Legal

Legal

Whistleblower complaints

Resolve Employee Concerns and Stop CMS Whistleblower Complaints

Make no mistake—your employees are being encouraged by CMS to report any suspected Medicare fraud. Whistleblower complaints. CMS offers an incentive to complainants of between 15% to 30% of any money they collect based on the data reported.  So, depending on the extent of the violation, this can easily add up to a significant financial […]
Published Date: April 22, 2021
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coordination benefits

Coordination of Benefits: Reduce Payment Delays with Six Simple Steps

QUESTION: We experienced an increase in Coordination of Benefits (COB) issues with Medicare last year. We finally found out there was a “glitch” in their system. The previous accident claim information was populating the primary insurance field. It took us quite a while to recover from this. What can we do to avoid issues like […]
Published Date: January 15, 2021
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Medical records copying fees

Avoid Copying Fees Violation, Pinpoint the Right Medical Records Rule

QUESTION: When a state has a cap on the allowed records copying rate, is there ever a situation that justifies exceeding the maximum allowance? Sometimes, the request for the records is for a long-term patient, so there are a lot of pages to copy. Would this case permit charging more than the allowed max charge […]
Published Date: October 22, 2020
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Refuse mask ADA

Stop Legal Nightmares When Your Staff Confront Face Mask Refusals

The sad reality is your front desk employees are being forced to police your patients’ compliance with local, federal, as well as your own face mask mandates. Arm your staff with the tools they need to be polite, uphold employment law, all while not violating the patient’s ADA rights. This guide walks you and your […]
Published Date: August 7, 2020
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Face Mask Policy

3 Face Mask Policy Don’ts That Protect Your Office

While most of your employees and patients will readily comply with face mask mandates, there are always exceptions. Having the right policy in place will help you properly handle refusals and keep your practice safe. Face mask policy. Avoid these face mask responses at all costs to stop charges of violating an employee, local, or […]
Published Date: July 24, 2020
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Terminate patient

Terminate a Patient Without Getting Sued

While it may seem a little unfair, patients can switch providers—no questions asked—with nothing more than a call to your practice asking to have records transferred. Unfortunately, when you’re the one making the split, terminating a patient-physician relationship isn’t so cut and dry—think abandonment lawsuit and medical malpractice. Before You Terminate a Patient… There are […]
Published Date: July 15, 2020
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Head Off $2 Million Medical Billing Fraud and Abuse Violation

You could be fined up to $11,000 for each false item or service you submit to Medicare. That means, your total penalty amount could be HUGE – reaching into the millions as it did for one physician practice. Halt massive penalties from crippling your practice by fixing these common medical billing fraud and abuse errors. […]
Published Date: June 25, 2020
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EKRA Violations Get 20 Years in Prison – Update Your Compliance Now!

Anyone in your practice could be soliciting kickbacks and your compensation arrangements could be in violation too. Those are two lessons learned from the first ever conviction for an EKRA violation committed by an 80-year-old office manager. ERKA violation: A Kentucky woman faces up to 20 years in prison for soliciting kickbacks from a toxicology […]
Published Date: February 3, 2020
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Immunization Laws for Healthcare Workers

Carrot or Stick: Immunization Laws for Healthcare Workers

As the flu season kicks into high gear, healthcare organizations are grappling with the reality that not all their employees are willing to roll up a sleeve and accept an influenza immunization — or any other vaccine for that matter. The big question is: Can you require your staff to get vaccinated? The answer is […]
Published Date: January 14, 2020
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Balance mistakes

Don’t Let Everyday Billing Mistakes Land You in Legal Hot Water

Billing mistakes have more serious implications than you just seeing a decrease in your reimbursement.  Some of the most common billing errors can get your practice audited, and result in you paying massive violation penalties. Unfortunately, accurately billing for outpatient services is so much more complicated than just submitting a claim or sending an invoice. […]
Published Date: December 17, 2019
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