AHLA Health Care Provider and Supplier Audits Practice Guide (AHLA Members)

AHLA Health Care Provider and Supplier Audits Practice Guide (AHLA Members) PDF Author:
Publisher:
ISBN: 9780769882505
Category :
Languages : en
Pages :

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Book Description
The U.S. Department of Health and Human Services' Center for Medicare and Medicaid Services (CMS) has used independent contractors to audit providers and suppliers for improper payments, and this use has increased exponentially over the last few years. It can often be difficult to determine if a contractor has exceeded its authority as not all Medicare contractor authority is publicly available, and CMS and the states haven't clearly identified where Medicaid contractors' authority is defined. Health Care Provider and Supplier Audits Practice Guide, First Edition is a useful guide to understanding the intricacies of the Medicare, Medicaid, and commercial payer regulatory environment.Coverage Includes:Introduction to audit contractor landscapeMedicare Part A and B contractor auditsMedicare Part C and D audits and appealsMedicaid auditsCommercial payer overpayment disputesAnyone who needs an understanding of Medicare, Medicaid, and commercial payer audits and overpayment demands will find Health Care Provider and Supplier Audits Practice Guide, First Edition a useful guide.The eBook versions of this title feature links to Lexis Advance for further legal research options.

AHLA Health Care Provider and Supplier Audits Practice Guide (AHLA Members)

AHLA Health Care Provider and Supplier Audits Practice Guide (AHLA Members) PDF Author:
Publisher:
ISBN: 9780769882505
Category :
Languages : en
Pages :

Get Book Here

Book Description
The U.S. Department of Health and Human Services' Center for Medicare and Medicaid Services (CMS) has used independent contractors to audit providers and suppliers for improper payments, and this use has increased exponentially over the last few years. It can often be difficult to determine if a contractor has exceeded its authority as not all Medicare contractor authority is publicly available, and CMS and the states haven't clearly identified where Medicaid contractors' authority is defined. Health Care Provider and Supplier Audits Practice Guide, First Edition is a useful guide to understanding the intricacies of the Medicare, Medicaid, and commercial payer regulatory environment.Coverage Includes:Introduction to audit contractor landscapeMedicare Part A and B contractor auditsMedicare Part C and D audits and appealsMedicaid auditsCommercial payer overpayment disputesAnyone who needs an understanding of Medicare, Medicaid, and commercial payer audits and overpayment demands will find Health Care Provider and Supplier Audits Practice Guide, First Edition a useful guide.The eBook versions of this title feature links to Lexis Advance for further legal research options.

Complete Healthcare Compliance Manual 2021

Complete Healthcare Compliance Manual 2021 PDF Author:
Publisher:
ISBN: 9781733598750
Category :
Languages : en
Pages :

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Book Description


Healthcare Fraud

Healthcare Fraud PDF Author: Rebecca S. Busch
Publisher: John Wiley & Sons
ISBN: 1118179803
Category : Business & Economics
Languages : en
Pages : 374

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Book Description
An invaluable tool equipping healthcare professionals, auditors, and investigators to detect every kind of healthcare fraud According to private and public estimates, billions of dollars are lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud, Second Edition provides tips and techniques to help you spot—and prevent—the "red flags" of fraudulent activity within your organization. Eminently readable, it is your "go-to" resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations. Includes new chapters on primary healthcare, secondary healthcare, information/data management and privacy, damages/risk management, and transparency Offers comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans Examines the necessary background that internal auditors should have when auditing healthcare activities Managing the risks in healthcare fraud requires an understanding of how the healthcare system works and where the key risk areas are. With health records now all being converted to electronic form, the key risk areas and audit process are changing. Read Healthcare Fraud, Second Edition and get the valuable guidance you need to help combat this critical problem.

GMP/ISO Quality Audit Manual for Healthcare Manufacturers and Their Suppliers, (Volume 2 - Regulations, Standards, and Guidelines)

GMP/ISO Quality Audit Manual for Healthcare Manufacturers and Their Suppliers, (Volume 2 - Regulations, Standards, and Guidelines) PDF Author: Leonard Steinborn
Publisher: CRC Press
ISBN: 0203026659
Category : Medical
Languages : en
Pages : 452

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Book Description
This well-known QA manual has been updated to provide the guidance readers need to assess their compliance with standard regulations. This Volume 2 of a three-part package contains the full text on: * FDA regulations* EC and IPEC guidelines* ISO/BSI standards referenced in the checklists furnished in volume 1Easy-to-read and organized to provide fa

Health Care Compliance Professional's Manual

Health Care Compliance Professional's Manual PDF Author: Wolters Kluwer and the American Health Law Association 
Publisher: Aspen Publishers
ISBN: 9781543822892
Category : Compliance
Languages : en
Pages : 1654

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Book Description
The Health Care Compliance Professional's Manual is one of the most vital, long-standing, and best known resources in the world of health care compliance. It has all the tools you and your compliance team need to plan and execute a customized compliance program. This new edition is filled with industry best practices, sample forms, policies, procedures, and much more to save you time and comply with federal standards. The Health Care Compliance Professional's Manual will help you to: Use OIG publications and Federal Sentencing Guidelines to plan and execute a customized compliance strategy that meets tough federal standards and minimizes enforcement risks Oversee physician compensation and referrals Perform risk assessments using matrixes with step-by-step instructions to pinpoint areas that pose compliance and operational risks Draft compliance policies that form the foundation for a strong compliance program Build a strong infrastructure reinforced by industry best practices Create an effective education and training program that instills in employees the importance of legal compliance Implement a privacy and security plan that ensures patient information is protected Stay up-to-date on the latest legal and state and federal regulatory requirements affecting your facility, in areas such as HIPAA, EMTALA, fraud and abuse, reimbursement, privacy, security, patient safety, and clinical research Study for CCB(R) Certification in Healthcare Compliance (CHC) Packed with tools to make your job easier and more efficient, The Health Care Compliance Professional's Manual will provide: Practical coverage of federal and state laws governing your facility Insight into helpful federal standards on effective compliance programs Step-by-step guidance on implementing a sound compliance program Examples of common risk areas and how to handle them Time savings and peace of mind from sample policies, checklists and forms from members of the American Health Law Association (AHLA) The Health Care Compliance Professional's Manual will help you protect your company if violations do occur: Learn how to apply auditing, monitoring, and self-assessment techniques for conducting internal investigations Discover how to successfully follow the OIG's voluntary disclosure program to resolve overpayment problems and avoid exclusion from Medicare Find out how to enter into a corporate integrity agreement to settle with the federal government and mitigate FCA-related penalties Document your compliance efforts so you leave a protective paper trail that shields you from liability And much more Previous Edition: Health Care Compliance Professional's Manual, Second Edition ISBN: 9781543813265 SKU: 10071961-7777

National Clinical Audits

National Clinical Audits PDF Author: David Pruce
Publisher: Royal College of Physicians
ISBN: 9781860161292
Category : Medical audit
Languages : en
Pages : 68

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Book Description


Gmp/Iso Quality Audit Manual for Healthcare Manufacturers and Their Suppliers

Gmp/Iso Quality Audit Manual for Healthcare Manufacturers and Their Suppliers PDF Author: Leonard Steinborn
Publisher: CRC Press
ISBN: 9780849318481
Category : ISO 9000 Series Standards
Languages : en
Pages :

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Book Description
This new edition continues a two-decade tradition of widely-used guidance for performing effective audits. Comprehensive in its coverage, this practical guide should prove a valuable tool that offers effective training for new auditors and updates current auditors on new standards and regulations. It helps defuse FDA inspectors frustration in not being able to view audit reports. When combined with a procedure, the checklists demonstrate that comprehensive auditing is part of the quality system.

Healthcare Compliance Auditor - The Comprehensive Guide

Healthcare Compliance Auditor - The Comprehensive Guide PDF Author: Viruti Shivan
Publisher: Independently Published
ISBN:
Category : Medical
Languages : en
Pages : 0

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Book Description
"Healthcare Compliance Auditor: The Comprehensive Guide" is an essential resource for professionals in the field of healthcare compliance and auditing. This in-depth book offers a thorough exploration of the complex world of healthcare regulations, providing readers with the knowledge and tools necessary to conduct effective and ethical compliance audits. It covers a wide range of topics including federal and state healthcare laws, risk assessment, auditing techniques, and the latest in compliance strategies. Key features of this guide include detailed explanations of healthcare laws such as HIPAA, HITECH, and the Affordable Care Act, as well as practical guidance on conducting audits, identifying risks, and implementing compliance programs. The book is designed to help both new and experienced auditors to develop a comprehensive understanding of the healthcare compliance landscape and to stay abreast of the evolving regulatory environment. Please note that this book contains no images or illustrations for copyright purposes, focusing solely on providing high-quality, text-based content. Whether you're a novice stepping into the world of healthcare auditing or a seasoned professional seeking to enhance your knowledge and skills, this book is an invaluable resource for ensuring compliance and upholding ethical standards in healthcare.

Corporate Compliance in Home Health

Corporate Compliance in Home Health PDF Author: Fay Adrienne Rozovsky
Publisher: Jones & Bartlett Learning
ISBN: 9780834211735
Category : Home care services
Languages : en
Pages : 536

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Book Description
Litigation is rampant in the home health field - and it's not just about billing and coding. It's also about other practices that could lead to compliance problems, such as substandard employment practices or failing to run background checks. A lawsuit against your agency could come completely out of left field. But you can avoid getting blind-sided and protect your agency. Corporate Compliance in Home Health: Establishing a Plan, Managing the Risks gives home health care providers practical, down-to-earth standards for controlling and preventing losses growing out of corporate compliance. With this new resource from Aspen, get an up-to-date and easy-to-understand review of the law of corporate compliance, find out how the new OIG (Office of the Inspector General of HCFA) model compliance guidance for hospitals impacts home health, and uncover where your agency is at risk. You'll find out what to do if and when your agency comes under investigation, and get important, timely federal reference material from the GAO to HHS, and key parts of the Federal Sentencing Guidelines.

Compliance

Compliance PDF Author: Cherilyn G. Murer
Publisher: McGraw-Hill Professional Publishing
ISBN:
Category : Law
Languages : en
Pages : 264

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Book Description
The Healthcare Financial Management Series. Practical and legal guide for financial managers and other healthcare professionals on how to create and manage a corporate compliance program. Topics included: principals of corporate criminal liability, compliance programs and the U.S. sentencing guidelines, and model programs.