EPIConferences
Compliance & Healthcare Innovation
May 19 - 21, 2023
Renaissance Resort, 500 S Legacy Trail, St. Augustine, FL 32092
2023-05-19 07:00:00
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News

08/312017

Healthcare Businesses Compliance and Liabilities

News by Dr. Jose Delgado

If you are in the healthcare arena; can you afford a $50,000 a day per violation fine?

I remember reading many years ago that farmers were the biggest gamblers as every year as they chance that their crops will be healthy but not too healthy so that they receive a fair price for their products. In today’s day and age, I think that Healthcare Professionals in the United States are the biggest gamblers as we spent many years studying before we hit the field and yet your next patient could be your last. Even worse, the compliance requirements in the…

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07/312017

Diagnosis Code Concerns and Awareness

News actuaries, billing companies, coding priority, Diagnosis code, EHR and diagnosis codes, ICD, ICD 10, ICD 9, maximum number of diagnosis, payment systems by Dr. Jose Delgado

Recently I was at a community meeting and a representative from the local Accountable Care Organization (ACO) spoke about the issue of some Providers reporting four diagnosis codes per visit.  At first, I didn’t think anything of it but then it dawned on me.  It is all about money.

Without going into actuaries, risks and costs formulas the point is simple, healthier individuals use less resources. This means that if you simply use a few codes you are telling Payors (insurance companies and Medicare) that your patients are healthier than others that use multiple codes. As a result, these Payors…

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07/302017

SRA’s are Here to Stay!

News Advancing Care Information, HIPAA, HIPAA Fines, HIPAA Security Risk Assessments, HITECH Audits, MACRA, meaningful use, Medicare Access and CHIP Reauthorization Act, Medicare payment system, MIPS, SRA by Dr. Jose Delgado

There have been some discussions as it regards the HIPAA Security Risks Assessments (SRA) and the requirement to perform one. Some rumors claim that SRA’s are no longer required as they were part of Meaningful Use and this program has been terminated. Other rumors claim that SRAs are only for Medicare Providers and that the same do not apply to those that do not treat the Medicare population. Our intent with this article is to get the record straight.

Conducting a HIPAA Security Risk Assessments (SRA) is a legal requirement that is not going anywhere. There have been some changes…

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07/292017

MACRA by the Numbers

News 2019 payment, APM, HIPAA risk assessment, MACRA, meaningful use, Medicare Access and CHIP Reauthorization Act, Medicare Payment, Medicare quality Measures, MIPS, PQRS, Security risk assessment by Dr. Jose Delgado

MACRA (the Medicare Access and CHIP Reauthorization Act) is in a simplistic way Medicare’s new payment system. MACRA was approved with bilateral support, in other words, is not going anywhere as democrats and republicans agreed and approved the same. MACRA also requires action from the Medicare Providers if they wish to maximize their Medicare reimbursement. Therefore, and based on the complexity of the same we have decided to provide you some key information in a numerical fashion as to increase understanding…

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06/012017

eClinical $155M Settlement

News $155M settlement, 155 million dollar settlement, eClinical, eClinical system flaws, EHR, false claims, health technology incentive payments, legal problems for EHRs, meaningful use, meaningful use attestations by Dr. Jose Delgado

eClinical, a Massachusetts company agreed to pay $155M to settle claims that they falsely obtained their Electronic Health Record (EHR) certification.

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act Providers and Organizations had the ability to claim a financial incentive for the implementation of electronic health records in their offices. Based on this incentive and the need to use a certified EHR over 125,000 providers selected to use eClinical. Regretfully, as stated in the Department of Justice’s release, eClinical’s product failed to meet the requirements of a certified EHR. While eClinical claims that they didn’t do… 

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05/302017

It is all about Systems

News Alaska Department of Health settlement, HIPAA Requirement, Increases efficiency, minimizes liability, offers protection from breaches, policies and procedures, reduces mistakes, security reminder, simplifies training, standardizes processes by Dr. Jose Delgado

Increases efficiency, standardizes processes, reduces mistakes, minimizes liability, offers protection from breaches, simplifies training. If you don’t know what we are talking about the answer is simple; policies and procedures.

Some people consider policies and procedures an administrative burden that is simply a waste of time yet others not only understand the need for the same but consider these policies and procedures a critical part of any process.

Perhaps a brief discussion of processes may be an easier way to visualize the importance of policies and procedures as no fast food restaurant or manufacturer could survive without clear processes and…

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