Download or read book Complete Healthcare Compliance Manual 2021 written by and published by . This book was released on 2021-04 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book The Physician Compliance Auditing and Monitoring Manual written by Bill Dacey and published by Delmar. This book was released on 2001 with total page 278 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Improving Healthcare Quality in Europe Characteristics Effectiveness and Implementation of Different Strategies written by OECD and published by OECD Publishing. This book was released on 2019-10-17 with total page 447 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

Download or read book Physician Compliance Auditing and Monitoring Guide written by Ingenix, Inc. Staff and published by . This book was released on 2001-11 with total page 260 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Government Auditing Standards 2018 Revision written by United States Government Accountability Office and published by Lulu.com. This book was released on 2019-03-24 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt: Audits provide essential accountability and transparency over government programs. Given the current challenges facing governments and their programs, the oversight provided through auditing is more critical than ever. Government auditing provides the objective analysis and information needed to make the decisions necessary to help create a better future. The professional standards presented in this 2018 revision of Government Auditing Standards (known as the Yellow Book) provide a framework for performing high-quality audit work with competence, integrity, objectivity, and independence to provide accountability and to help improve government operations and services. These standards, commonly referred to as generally accepted government auditing standards (GAGAS), provide the foundation for government auditors to lead by example in the areas of independence, transparency, accountability, and quality through the audit process. This revision contains major changes from, and supersedes, the 2011 revision.

Download or read book Standards for Internal Control in the Federal Government written by United States Government Accountability Office and published by Lulu.com. This book was released on 2019-03-24 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt: Policymakers and program managers are continually seeking ways to improve accountability in achieving an entity's mission. A key factor in improving accountability in achieving an entity's mission is to implement an effective internal control system. An effective internal control system helps an entity adapt to shifting environments, evolving demands, changing risks, and new priorities. As programs change and entities strive to improve operational processes and implement new technology, management continually evaluates its internal control system so that it is effective and updated when necessary. Section 3512 (c) and (d) of Title 31 of the United States Code (commonly known as the Federal Managers' Financial Integrity Act (FMFIA)) requires the Comptroller General to issue standards for internal control in the federal government.

Download or read book AHLA Health Care Compliance Legal Issues Manual Non members written by American Health Lawyers Association and published by . This book was released on 2019 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Authored by experts with years of health care compliance experience, this new edition integrates changes in regulation, trends in enforcement, and the reasoning of the courts to help you navigate emerging and unsettled areas of compliance risk, such as self-disclosure obligations, risks associated with opioid use, and the impact of statistical sampling.Highlights of this edition include:All new glossary of health care compliance terms, including key statutes, acronyms, governing agencies, and moreExpanded civil monetary penalty and exclusion authorities under 2017 final rulesDiscussion of core elements of compliance programs for Medicare Advantage Plans and Part D Plans as established by federal regulationsExpanded whistleblower protections under federal and state law, false claims based on lack of medical necessity, materiality after Escobar, and recent enforcement activityExpanded discussion of determinations of medical necessity, CMS review of medical necessity terminations, consequences, and appeals processesRecent health information privacy and security developments, including new guidance, risks associated with innovative technologies, and trends in Health Insurance Portability and Accountability Act (HIPAA) enforcement activityNew chapters:Chapter 1, Glossary of Key TermsChapter 10, The Relationship between Enforcement and ComplianceChapter 17, Health Care Civil Rights and Nondiscrimination Under Section 1557 of the Affordable Care ActChapter 19, Behavioral Health

Download or read book Federal Information System Controls Audit Manual FISCAM written by Robert F. Dacey and published by DIANE Publishing. This book was released on 2010-11 with total page 601 pages. Available in PDF, EPUB and Kindle. Book excerpt: FISCAM presents a methodology for performing info. system (IS) control audits of governmental entities in accordance with professional standards. FISCAM is designed to be used on financial and performance audits and attestation engagements. The methodology in the FISCAM incorp. the following: (1) A top-down, risk-based approach that considers materiality and significance in determining audit procedures; (2) Evaluation of entitywide controls and their effect on audit risk; (3) Evaluation of general controls and their pervasive impact on bus. process controls; (4) Evaluation of security mgmt. at all levels; (5) Control hierarchy to evaluate IS control weaknesses; (6) Groupings of control categories consistent with the nature of the risk. Illus.

Download or read book United States Attorneys Manual written by United States. Department of Justice and published by . This book was released on 1985 with total page 720 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book The CMS Hospital Conditions of Participation and Interpretive Guidelines written by and published by . This book was released on 2017-11-27 with total page 546 pages. Available in PDF, EPUB and Kindle. Book excerpt: In addition to reprinting the PDF of the CMS CoPs and Interpretive Guidelines, we include key Survey and Certification memos that CMS has issued to announced changes to the emergency preparedness final rule, fire and smoke door annual testing requirements, survey team composition and investigation of complaints, infection control screenings, and legionella risk reduction.

Download or read book Federal Contract Compliance Manual written by United States. Office of Federal Contract Compliance Programs and published by . This book was released on 1990 with total page 1110 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Insurance Handbook for the Medical Office written by Marilyn Fordney and published by Elsevier Health Sciences. This book was released on 2013-01-01 with total page 683 pages. Available in PDF, EPUB and Kindle. Book excerpt: A complete guide to insurance billing and coding, Insurance Handbook for the Medical Office, 13th Edition covers all the plans that are most commonly encountered in clinics and physicians' offices. Its emphasis on the role of the medical insurance specialist includes areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. Learning to fill in the claim form accurately is made easier by the use of icons for different types of payers, lists of key abbreviations, and numerous practice exercises. This edition provides the latest on hot topics such as ICD-10, healthcare reform, the new CMS-1500 form, and electronic claims. Trusted for more than 30 years, this proven reference from Marilyn Fordney prepares you to succeed as a medical insurance professional in any outpatient setting. Emphasis on the business of running a medical office highlights the importance of the medical insurance specialist in filing clean claims, solving problems, and collecting overdue payments.Key terms and key abbreviations are defined and emphasized, reinforcing your understanding of new concepts and terminology.Detailed tables, boxes, and illustrations call out key points and main ideas.Unique! Color-coded icons clarify information, rules, and regulations for different payers.An Evolve companion website enhances learning with performance checklists, self-assessment quizzes, and the Student Software Challenge featuring cases for different payer types and an interactive CMS-1500 form to fill in.A workbook contains learning tips, practice exercises for key terms and abbreviations, review questions, study outlines, performance objectives, a chapter with practice tests, and critical thinking activities for hands-on experience with real-world cases. Available separately. Updated coverage of key health insurance topics includes HIPAA compliance, the HITECH Act, health reform of 2010, electronic health records, electronic claims, ICD-10, NUCC standards, Physician Quality Reporting System (PQRS) Incentive Program, Meaningful Use, and CPT 2013.Updated ICD-10 coding information prepares you for the October 2014 ICD-10 implementation date.Updated content on claim forms includes block-by-block explanations and examples for the new CMS-1500 Claim Form.Updated guidelines for the filing and submission of electronic claims include sample screenshots and prepare you for the future of the medical office.

Download or read book Consolidated Audit Guide for Audits of HUD Programs written by and published by . This book was released on 1991 with total page 132 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Managing Legal Compliance in the Health Care Industry written by George B. Moseley III and published by Jones & Bartlett Publishers. This book was released on 2013-09-20 with total page 598 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managing Legal Compliance in the Health Care Industry is a comprehensive text that prepares students for this increasingly critical field in health care administration. In three sections, this unique title first examines all the key laws and regulations that health care organizations must comply with. In section two, it explores in detail the seven essential ingredients for a good compliance program. In the final section, the book explains how the compliance program must be adapted to the special needs of different types of health care organizations. Designed for graduate level students in programs of public health, health administration, and law, the text is filled with highly practical information about the ways that legal violations occur and how good compliance programs function. Key Features: - Examines in detail the current laws and regulations with which all types of health care organizations must comply - Explore the seven essential ingredients for a good compliance program - Looks at compliance programs within twelve different types of health care organizations - References real world cases of fraud and abuse - Includes Study Questions and Learning Experiences in each chapter that are designed to encourage critical thinking

Download or read book The Health Care Compliance Professional s Manual written by Hcca and published by Aspen Publishers. This book was released on 2007 with total page 1080 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Health Care Compliance Professional's Manual gives you all the tools you need to plan and execute a customized compliance program that meets federal standards. It walks you through the entire process, start to finish, showing you how to draft compliance policies, build a strong compliance infrastructure in your organization, document your efforts, apply self-assessment techniques, create an effective education program, pinpoint areas of risk, conduct internal probes and much more. The Health Care Compliance Professional's Manual is used by the Health Care Compliance Association (HCCA) as the basic text for its Compliance Academy - the program that prepares compliance professionals for the CHC (Certificate in Healthcare Compliance) certification exam. The Health Care Compliance Professional's Manual will help you to: Use OIG publications and Federal Sentencing Guidelines to help plan and execute a customized compliance strategy that meets tough federal standards Perform risk assessment to pinpoint areas within your company that pose compliance and operational risks Draft compliance policies that form the foundation for a strong compliance program Build a strong infrastructure for compliance to work, including hiring the right personnel Create an effective education and training program that instills in employees the value of legal compliance Conduct internal probes that uncover legal violations before the federal government does - and mitigate possible penalties Stay up-to-date on all the latest legal and regulatory requirements affecting your facility, including HIPAA, EMTALA, fraud and abuse reimbursement, privacy, security, patient safety and much more! Packed with tools to make your job easier, The Health Care Compliance Professional's Manual will provide: Practical coverage of federal and state laws governing your facility Document efforts and apply self assessment techniques Insight into helpful federal standards on effective compliance programs Step-by-step guidance on implementing a sound compliance program Time-saving sample compliance policies, forms, checklists, and chart The Health Care Compliance Professional's Manual will protect your company if violations do occur: Learn how to apply auditing, monitoring, and self-assessment techniques Discover how to successfully follow the OIG's voluntary disclosure program to resolve overpayment problems and avoid exclusion from Medicare Find out how to enter into a corporate integrity agreement to settle with the federal government and mitigate FCA-related penalties Document your compliance efforts so you leave a protective paper trail that shields you from liability And much more

Download or read book Clinical Practice Guidelines We Can Trust written by Institute of Medicine and published by National Academies Press. This book was released on 2011-06-16 with total page 217 pages. Available in PDF, EPUB and Kindle. Book excerpt: Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.

Download or read book Insurance Handbook for the Medical Office E Book written by Marilyn Fordney and published by Elsevier Health Sciences. This book was released on 2014-08-27 with total page 683 pages. Available in PDF, EPUB and Kindle. Book excerpt: A complete guide to insurance billing and coding, Insurance Handbook for the Medical Office, 13th Edition covers all the plans that are most commonly encountered in clinics and physicians’ offices. Its emphasis on the role of the medical insurance specialist includes areas such as diagnostic coding, procedural coding, Medicare, HIPAA, and bill collection strategies. Learning to fill in the claim form accurately is made easier by the use of icons for different types of payers, lists of key abbreviations, and numerous practice exercises. This edition provides the latest on hot topics such as ICD-10, healthcare reform, the new CMS-1500 form, and electronic claims. Trusted for more than 30 years, this proven reference from Marilyn Fordney prepares you to succeed as a medical insurance professional in any outpatient setting. Emphasis on the business of running a medical office highlights the importance of the medical insurance specialist in filing clean claims, solving problems, and collecting overdue payments. Key terms and key abbreviations are defined and emphasized, reinforcing your understanding of new concepts and terminology. Detailed tables, boxes, and illustrations call out key points and main ideas. Unique! Color-coded icons clarify information, rules, and regulations for different payers. An Evolve companion website enhances learning with performance checklists, self-assessment quizzes, and the Student Software Challenge featuring cases for different payer types and an interactive CMS-1500 form to fill in. A workbook contains learning tips, practice exercises for key terms and abbreviations, review questions, study outlines, performance objectives, a chapter with practice tests, and critical thinking activities for hands-on experience with real-world cases. Available separately. Updated coverage of key health insurance topics includes HIPAA compliance, the HITECH Act, health reform of 2010, electronic health records, electronic claims, ICD-10, NUCC standards, Physician Quality Reporting System (PQRS) Incentive Program, Meaningful Use, and CPT 2013. Updated ICD-10 coding information prepares you for the October 2014 ICD-10 implementation date. Updated content on claim forms includes block-by-block explanations and examples for the new CMS-1500 Claim Form. Updated guidelines for the filing and submission of electronic claims include sample screenshots and prepare you for the future of the medical office.