Events Fraud Overpayments 
AIHC
FEBRUARY 17, 2025
When Audit Managers Knowingly Skew Audit Results Written by Carl J Byron , CCS, CHA, CIFHA, CMDP, CPC, CRAS, ICDCTCM/PCS, OHCC and CPT/03 USAR FA (Ret) Fraud cannot be eliminated. No system is completely fraud-proof, as any system can be bypassed or manipulated. on fraud detection and prevention in healthcare.
HIPAA Journal
MARCH 30, 2022
Had HIPAA not addressed these issues, subsequent events in HIPAA history may never have happened. Had the level of abuse and fraud in the healthcare industry been allowed to continue, tens of billions of dollars would have been lost to unscrupulous actors. Abuse and Fraud in the Health Care Industry. $7 In March 1996, Rep.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
HIT Consultant
JANUARY 9, 2024
Varying levels of economic development and legal systems lead to potential fraud and currency control complications as well. The integration of key clinical data from EDC systems, study budgets, agreements and schedules of events enables automated invoicing for streamlined efficiency and prevent payment errors.
Health Law RX
NOVEMBER 9, 2021
For the first time since 2013, on November 8, 2021, the Department of Health and Human Services Office of Inspector General (“OIG”) updated its Health Care Fraud Self-Disclosure Protocol (“SDP”). Such providers must still separately report Reportable Events to the OIG pursuant to the CIA.
Compliancy Group
FEBRUARY 7, 2024
CMS UPIC audits are designed to identify and prevent fraud, waste, and abuse within Medicare and Medicaid, ensuring that federal funds are used appropriately and that the services billed for are actually provided and are medically necessary. Given their significant impact, healthcare organizations must take UPIC audits seriously.
Compliancy Group
FEBRUARY 29, 2024
A Corporate Integrity Agreement outlines the healthcare entity’s future compliance obligations and the steps to prevent future fraud, abuse, and illegal activity incidents. Being able to opt into a Corporate Integrity Agreement typically depends on the severity and nature of the infraction and the entity’s previous compliance record.
Medisys Compliance
MARCH 7, 2022
These are usually just innocuous mistakes that do not represent any intent to commit billing fraud. In the unfortunate event when you receive such overpayment demand letters, don’t acquiesce without conducting an analysis first. One error of this nature can lead to a reviewer casting aspersions on the integrity of your note.
Expert insights. Personalized for you.
52 
Let's personalize your content