Practice Management

Record Cloning and "Spinners" Attract CMS Gaze"

The Centers for Medicare and Medicaid (CMS) requires that all treatments it pays for be medically necessary. CMS normally reimburses fairly quickly, then audits submitted claims to detect cases where treatment should not have been authorized. Doctors demonstrate the medical necessity of their claims by submitting, when requested, the documentation on cases that the auditors have flagged. If submitted documentation justifies the treatments paid for, the claim will be upheld. If not, then the government asks for its money back, and fines may be imposed.

Who, Outside of My Office, Do I Need to Talk to About the ICD-10 Transition?

Who, outside of my office, do I need to talk to about the ICD-10 transition?

Can You Charge for Requests for Records?

By Samuel A. Collins
Feb 2010


I am getting numerous requests for records from patients, attorneys and third parties. I believe I can charge for this, but how much can I charge and are there specific codes that must be used?


Voluntary Disclosure--Look Before you leap

Here are steps that every provider should consider before disclosing information to the government. After reviewing this advisory from Robert G. Homchick, Esq. from one of our law firms, we felt that it could be of great value to many of our readers. For more information contact Davis, Wright and Tremaine at The original posting date for this article was Aug 2008.

Protected Health Information De-Identification Standards

On November 26, 2012, the OCR released specific guidance regarding the de-identification of Protected Health Information (PHI). This guidance is the result of input from experts in various fields, workshops and in-depth research regarding various de-identification approaches. The intent of this guidance was to assist covered entities to understand:

HIPAA Final Rule Strengthens Privacy and Security Protections

On January 17, 2013, the long awaited final rule was announced. It will be published in the Federal Register on January 25, 2013. Providers need to be aware that the final rule, which replaces the current interim rule, is effective on March 26, 2013. The compliance deadline for covered entities is September 23, 2013.

Are You Compliant with the New HIPAA Regulations?

September 23rd, 2013 was the deadline for HIPAA Omnibus Final Rule compliance. It seems to have just snuck up on everybody. We have spoken with some clincis who say that they don't need to worry about it because ”they are just a small practice.” Please, do not wait any longer to get compliant!

Windows XP No Longer HIPAA Compliant (Resource 312)

For anyone who is not a computer techie, the announcement by Microsoft about discontinuing support for Windows XP may not mean much.

Fee Resources (Resource 171)

The establishment of appropriate fees for services is one of the greatest challenges in health care. You need to understand the following concepts:

Claims Processing (Resource 199)

A properly completed claim (whether paper or electronic) is a critical component of the reimbursement process. A clean claim is vital to the processing and payment of your claims. The "cleaner" the claim, the faster you will receive payment. It is the responsibility of the provider to understand what is needed and required by the carrier, then provide that information in the specified manner and time frame.

You need to understand the following concepts:


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