Billing Compliance

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5 Key Metrics to Watch to Understand If Your Audit Program Is Effective

No matter what job you have, producing measurable results is an expectation. A CEO is measured by the value of…

Why You Need More Ways to Benchmark Than Just CMS Data

Medical claims and billing data is the currency that drives your audit and compliance program. The data you are generating…

Innovating In a Crisis – Turning Challenges Into Opportunities

When I wrote this blog at the end of 2019 laying out our MDaudit Enterprise platform vision, I never had…

CommonSpirit Health’s Smooth Transition to MDaudit Enterprise

The continuing growth of regulatory compliance demands in the healthcare industry—and the heightened risk that accompanies it—is placing an enormous…

5 Ways to Use Prospective Audits to Boost Your Bottom Line

Financial health in today’s healthcare organizations is dependent on a revenue cycle that speeds claim approval and reimbursement. Amid tight…

University of Utah Health Enhances Retrospective Audits

Even before the COVID-19 pandemic dealt a significant blow to their bottom lines, hospitals, and health systems nationwide were functioning…

HCC model: Down to the Basics from Coding to Documentation

The Basics Hierarchical Condition Categories (HCC) were mandated in 1997 by the Centers for Medicare and Medicaid Services (CMS) and…

Provider Education: Comparative Billing Reports (CBR) and the MDaudit Platform

In 2020, CMS stepped up the creation and distribution of Comparative Billing Reports (CBRs). These reports are designed to be…

Accelerated Adoption Amid COVID-19 Heightens Telehealth Reimbursement Risks

COVID-19—and the resulting move by the Centers for Medicare and Medicaid Services (CMS) to expand reimbursement for its use—has pushed…

Billing Compliance and Revenue Cycle Challenges in Today’s Turbulent Environment

The healthcare industry has been under duress for the past decade for a number of reasons: transition to value based…

Healthcare’s Evolving Reimbursement Imperative

Reimbursement is becoming increasingly complex for today’s providers. And while it is fair to say that a certain amount of…