Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM       This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations. This information is not all-inclusive and is not intended as consulting or legal advice. HITECH is a critical aspect of the Health Insurance Portability & Accountability Act (HIPAA).  Since 2009, HITECH has given “tee ..read more

Why do interviewees try to deceive you?    Written by Meric Craig Bloch, Certified Fraud Examiner, Certified Financial Crime Specialist, Certified Compliance and Ethics Professional-Fellow, Professional Certified Investigator     Does the name Meric Craig Bloch “ring a bell”?  If you completed the AIHC Internal Forensic Auditor - Conducting Investigations certification course, then it should!  Meric is the author of the textbook for the investigative interviewing lessons. One of the biggest challenges we face when investigating a complaint as a healthcare adminis ..read more

Written by the AIHC Education Department     This article provides an overview of how the media and government are reacting to the potential of artificial intelligence (AI) and potential threats associated with this advanced technology.  Please read other AI articles published by the American Institute of Healthcare Compliance regarding how AI can advance quality of care, how AI is regulated, use of AI and HIPAA privacy/security, to name a few topics. A Government-Commissioned Report Released February 2024 The U.S. State Department commissioned the first-ever assessm ..read more

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department     Introduction    The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023.  The GCPG is a reference guide for the health care compliance community and other health care stakeholders and provides information about relevant Federal laws, compliance program infrastructure, OIG resources, and other information useful to understanding health care compliance. The GCPG standardized the seven Elements of a Successful C ..read more

This article provides an introduction to Artificial Intelligence, large multi-modal models and the impact on health care.  This information is not intended as legal or consulting advice.  Please utilize resources provided within this article for more information.      During the design and development of machine-learning models (aka general-purpose foundation models), the responsibility rests with the developers. A general-purpose foundation model can be used by a third party (a “provider”) through an active programming interface for a specific purpose or use. Governm ..read more

This article provides a basic overview of Artificial Intelligence, Telehealth, Asynchronous Services and HIPAA privacy concerns.  This information is not intended as legal or consulting advice.  Please utilize resources provided within this article for more information.    Telehealth refers to a collection of methods to enhance health care delivery and education — it’s not a specific service.  Synchronous telehealth is a virtual interaction between a patient and a provider that takes place in real time, like a video call, audio call, or secure text messaging. It usual ..read more

Written by:  Corliss Collins, BSHIM, RHIT, CRCR, CSM, CCA, CBCS, CPDC, Sheryn Honest, MBA, MLS, CHCO, CHA, CPC, Wendy Bartko, CPC, CEMC, CPMA, CPCO, CRC, CHA, CMDP, CIFHA     This article on Value-Based Care (VBC) addresses the importance of understanding the basics of data analytics to ensure C-Suite Executives have accurate information to make sound business decisions when engaging in new payment methodologies.  We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. Why this Trend of Value-Based Care? A 2022 report from t ..read more

Written by the AIHC Blogger     1 of Every 3 People in U.S. Will Get Herpes Zoster (Shingles).  This topic has been requested by AIHC members for educational purposes.  Due to the high stress levels experienced not only for healthcare workers, but in our society in general, shingles left untreated increases the risk of other complications related to the virus.  Is there a correlation between stress and outbreaks of shingles? Stress is at an all-time high.  Inflation, war in foreign countries, our population suffering from social determinants of health issue ..read more

Written by: James Smith    Introduction In the complex world of healthcare billing, mental health services require a tailored approach due to the unique nature of the field. With the year 2023 underway, mental health billing services face challenges and opportunities. Among the essential aspects of this process is effective denial management. This article explores the key components of a robust denial management process and why it is particularly important for mental health billing services this year. Understanding Denial Management Denial management involves a series of strategic ..read more

Written by the AIHC Education Volunteer Committee Contributors: Nancie Cummins, Sheryn Honest, Joanne Byron    This article is written to help educate individuals new to HIPAA & HITECH compliance by addressing the basic elements needed for a health care organization and/or business associate to be in compliance with Health Information Technology for Economic and Clinical Health (HITECH).  The focus of this article is to “connect the dots” between Health Insurance Portability & Accountability Act (HIPAA) and HITECH regarding privacy and security of electronically protec ..read more