Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Practice Support

Subcategories:Billing/CodingEMRsFacilityInsuranceQuality Assurance/ImprovementTechnologyWorkforce

Practice Page: Protecting Your Practice through Compliance

  |  

Compliance programs are an effort by the government to maintain integrity in the healthcare system. These programs target activities causing improper payment to determine their root cause: Was it a mistake or error, was it inefficiency or waste of resources, is the provider bending the rules or abusing the system, or was it intentional deception or fraud? There are also laws dictating the compliance culture within practices and institutions; for example, red-flag rules, antikickback statute, and stark law, to name a few.

Stage 2 of the EHR Incentive Program

  |  

Although reporting for Stage 1 of the Centers for Medicare and Medicaid Services (CMS) Electronic Health Record (EHR) Incentive Program began just this year, the rules, objectives, and measures for Stage 2 are already being established. Last June, the Office of the National Coordinator (ONC) for Health Information Technology (IT) presented CMS with its recommendations for Stage 2 of the CMS EHR Incentive Program which builds on the Stage 1 objectives supporting EHR utilization for data capture and sharing.

MUEs and Muscular Ultrasound Guidance: An Unlikely Story

  |  

Medically Unlikely Edits (MUEs) were launched on January 1, 2007 by the Centers for Medicare and Medicaid Services (CMS) to reduce the paid claims error rate for Medicare Part B claims. The function of MUEs is to detect and deny unlikely CMS claims for a Medicare patient on a single, 24-hour date of service on a prepayment basis. This is achieved by limiting the frequency of services provided by a physician or medical supply company.