Written By Teresa Bolden, CPC, CPMA, CEMC, CHBS, Medicare Compliance Consultant      Root Cause Analysis (RCA) is an important claims management tool to improve billing compliance.  It is a systematic problem-solving technique used to identify the underlying causes of a particular issue or problem, rather than addressing only its symptoms. It involves a structured approach to investigating and understanding why something happened, with the goal of preventing its recurrence. Applying RCA to analyze how and why claims are denied not only improves your bottom line, but r ..read more

Written by Joanne Byron, BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS of the American Institute of Healthcare Compliance (AIHC), a non-profit healthcare education organization.        The effective date of the Final Rule was June 25, 2024 with a compliance date of December 23, 2024.  Affected organizations must implement a new Attestation Form by the compliance date and update their Notice of Privacy Practices (NPP or NOPP) by February 16, 2026.  This article provides guidance regarding the Final Rule with links to additional informa ..read more

Part 4 in a series of articles to support World Elder Abuse Awareness  Written by Joy Rose, MSA, RHIA, CCS, CHA, CHPS      ICD-10-CM Rules for Coding Abuse World Elder Abuse Awareness Day was June 15.  Adult and child abuse, neglect and other maltreatment is unfortunately prevalent in society, and many believe that these cases are underreported (refer to the June 2024 article “Detecting Abuse of the Elderly” Part 2 in a series of AIHC Elder Abuse Awareness Training for your Workforce articles).  It is not uncommon for providers to evaluate suspected or confirmed ..read more

Part 3 in a series of articles to support World Elder Abuse Awareness Written by Joanne Byron, BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS of the American Institute of Healthcare Compliance (AIHC), a non-profit healthcare education organization. AIHC is sharing this information in support of World Elder Abuse Awareness Day.  The information below is not all-inclusive or comprehensive, but it is a good start to increase awareness to educate your workforce, patients, caregivers and family members.  Please feel free to repost, print and make available to your wo ..read more

Warning Signs of Elder Physical, Sexual, Psychological Abuse, Abandonment and Neglect Part 2 in a series of articles to support World Elder Abuse Awareness Written by Joanne Byron, BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS of the American Institute of Healthcare Compliance (AIHC), a non-profit healthcare education organization. Elder Abuse Awareness for the Healthcare Workforce The Department of Justice lists the following information that can be used by nurses, physicians and healthcare workforce members.  AIHC is sharing this information in support of World El ..read more

Part 1 in a series of articles to support World Elder Abuse Awareness Written by Joanne Byron, BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS    Please feel free to repost, print and make available to your workforce members. Detecting elder abuse can be difficult.  AIHC is publishing a series of articles to help providers and workforce members detect potential abusive situations in support of World Elder Abuse Awareness Day which is recognized on June 15th. Please feel free to repost, print and make available to your workforce members.  This infor ..read more

Authored by Corliss Collins, BSHIM, RHIT, CRCR, CSM, CCA, CBCS, CPDC    Founder. Principal and Managing Consultant      This is Part 7 in a series of articles providing a general overview of Artificial Intelligence (AI) impacting the healthcare industry.  This information is an overview of very basic suggestions on Standard Operating Procedures (SOP), Policies and Best Practices for smaller hospitals and provider organizations. This information is not designed to be all-inclusive. and is not intended as consulting or legal advice. Introduction The Health Lead ..read more

Written by Corliss Collins, BSHIM, RHIT, CRCR, CSM, CCA, CBCS, CPDC    Artificial Intelligence (AI) and Revenue Cycle Management (RCM) are hot topics in the healthcare industry.  Optimizing RCM across all payment and reimbursement models can reduce overhead and improve accuracy which results in allowing your RCM workforce to focus on financial counseling and other important area requiring personal interactions with your patients and conducting pre and post documentation and coding audits.  This article addresses what Chief Financial Officers (CFOs) and other C-Suite execu ..read more

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 administ ..read more