Mastering the language of medical coding and billing is one of the greatest challenges facing medical practices today. Submission of incomplete or inaccurate claims results in claim denials, delayed payments, and additional work for staff. While optimizing the clean claim ratio takes time, effort, and quality control, it is a critical step toward improving revenue cycle management. Here are 12 strategies to minimize claim denials and ensure timely payments for your practice.

The U.S. Department of Health and Human Services, Office for Civil Rights (OCR), has announced a Health Insurance Portability and Accountability Act of 1996 (HIPAA) civil money penalty on the impermissible disclosure of unsecured electronic protected health information (ePHI).  Children’s Medical Center of Dallas (Children’s) did not file a timely request for a hearing by the date in accordance with the instructions in the Notice of Proposed Determination and have paid the full civil money penalty of $3.2 million. Read the HHS Press Release Read the Notice of Proposed [...]

A receiver appointed to liquidate the assets of Filefax, Inc. has agreed to pay $ 100,000 out of the receivership estate to the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) in order to settle potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. Filefax, located in Northbrook, Illinois, advertised that it provided for the storage, maintenance, and delivery of medical records for covered entities. Although Filefax shut its doors during the course of OCR’s investigation into alleged HIPAA violations, [...]

The HIPAA Privacy Rule establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically. The Rule requires appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. The Rule also gives patients rights over their health information, including rights to examine and obtain a copy of [...]

The HIPAA Rules are flexible and scalable to accommodate the enormous range in types and sizes of entities that must comply with them. This means that there is no single standardized program that could appropriately train employees of all entities. Free CME Training to Educate Providers about the HIPAA Right of AccessOCR has launched a video training module for health care providers on patients’ right of access under the HIPAA Privacy Rule.  The video module provides an in-depth review of the components of the HIPAA right of access and ways in which it [...]