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Risk Analyses vs. Gap Analyses - What is the difference? Understanding the latest guidance from the Office for Civil Rights.

By Tom Meadows, HIPAA Compliance Officer, HIPAAwise.com On May 1st, the OCR released new information regarding a covered entities responsibility for completing an appropriate risk analysis.  Based on the dismal results that were achieved during the...

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De-Junk the Digital - Spring Cleaning Your Cyber Life

It’s that time of year for the highly anticipated or dreaded, Spring Cleaning! While you may be noticing the cobwebs in your ceiling corners as you begin writing your cleaning checklist, it’s just as important to clean out the digital cobwebs...

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spring clean

How to Stay in Debt - Crushing Habits

Nobody wants to be consumed with worrying about their finances. Debt for most people is a fact of life. Unless you have a stroke of luck with the lottery, or a Daddy Warbucks, you are probably unable to pay cash for life’s most important purchases:...

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good debt

Appeals settlements: SCF or LVA...Should I choose one or none at all?

If you have appeals pending at the Administrative Law Judge level awaiting a hearing, then you have probably heard a lot of buzz around CMS settlement processes. One option is the Settlement Conference Facilitation (SCF), an alternative dispute resolution...

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KX Modifier required on Oxygen Claims on or after August 1, 2018

On May 10, 2018, the DME MACs published a joint article, Correct Coding – Submitting Oxygen Claims with Modifiers KX, GA, GY, and GZ. The article provides guidance in modifier usage so that liability is appropriately assigned when coverage is or is...

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Orthotics and Telehealth – Am I violating the Anti-Kickback Statute?

The last few years have been especially difficult for suppliers of orthotic braces. As orthoses continue to be at the top of CMS’ list of audited codes, auditors continue to find new and creative ways to deny claims. As of late, denials related to telehealth...

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Lower Limb Orthoses Continue to be in the Spotlight

In this week's edition of the CMS Medlearn Matters newsletter CMS introduced the Provider Compliance Tips for Ordering Lower Limb Orthoses fact sheet. As background, the Medicare Fee-For-Service improper payment rate for lower limb orthoses was 66.7...

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