Claims Compliance News

Electronic Medical Records: What Your Data Can Tell You
(August 21, 2012) One of the perceived advantages of electronic medical records is that physicians will have a wealth of information that can help them gain greater insight about patients. The process of gathering and examining this information is called data analytics. For practices that are applying for federal bonuses for meaningful use of technology, or planning to work with accountable care organizations, analytics will be critical for proving that a practice is doing well enough to earn a bonus . . . (Source: American Medical News)

Aug. 21: EHR Vendor Selection News and Health IT Updates
(August 21, 2012) Good Neighbor Community Health Center (Columbus, NE) achieves Medicaid meaningful use: Vitera Healthcare Solutions, one of the nation’s largest providers of electronic health records and practice management software and services, announced today that Nebraska’s East Central Health Department’s Good Neighbor Community Health Center has achieved meaningful use with the company’s electronic health records (EHR) solution. The health center was the first beneficiary of Nebraska Medicaid’s recently launched EHR incentive program. Trinitas Regional Medical Center (Elizabeth, NJ) picks Hyland: . . . (Source: EHR Intelligence)

Relationship Between EHR and Patient Engagement
(August 21, 2012) Everyone is familiar with the typical visit to the medical clinic. It’s what we’ve come to know as the transactional experience in healthcare. It begins with the check-in between patient and clerical staff, followed by the face time for the patient with the clinical staff, and ends with the check-out for the patient back where she started in the reception area. The understanding that patients have learned about this experience is that you make an appointment at the clinic when you think there might be some type of problem with your health . . . (Source: EHR Intelligence)

Health Law Gives Medicare Fraud Fighters New Weapons
(August 21, 2012) Fighting health care fraud in the U.S. can seem like an endless game of Whack-a-Mole. When government fraud squads crack down on one scheme, another pops up close by. But the fraud squads that look for scams in the federal Medicare and Medicaid programs have some new weapons: tools and funding provided by the Affordable Care Act . . . (Source: WBUR)

Do Providers Truly Experience Promised Cost-savings With Electronic Medical Records (EMR) Adoption?
(August 20, 2012) Most providers and healthcare investors are aware of state and federal government incentives available for adopting electronic medical records (EMR) systems. And while the start up costs inherent in EMR adoption can be daunting, the cost savings associated with EMR adoption (which are on top of federal and state incentives for adoption) have also been widely discussed . . . (Source: Lexology)

DSS, Inc. Sponsors This Year's VistA Expo & Symposium
(August 20, 2012) DSS, Inc. announced that it is a co-sponsor of the 2012 VistA Expo & Symposium to be held September 11-14th, 2012 in Seattle, Washington. As a key member of the VistA EHR business community, DSS, Inc. is dedicated to the further development and adoption of VistA through support of the Expo . . . (Source: Business Wire)

EHR vendor selection news and health IT updates
(August 20, 2012) Virginia Physicians (Richmond, VA) picks eClinicalWorks: eClinicalWorks, a market leader in ambulatory clinical systems, today announced that Virginia Physicians, Inc., the largest independent multi-specialty practice in the Richmond metropolitan area, has chosen eClinicalWorks comprehensive electronic health records (EHR) solution for its 58 providers across eight locations. Orthopaedic Associates of Central Maryland (Baltimore, MD) chooses ChartLogic . . . (Source: EHR Intelligence)

Physician Series: OB/GYN EHR Hurdles
(August 20, 2012) Part II of our physician series with Cindy Basinski, MD and OB/GYN, focuses on how she uses EHR from a technical standpoint, such as ICD-9 codes. It can be hard for physicians to collaborate with an IT department on selecting vendors and products. Basinski also provides her opinions on meaningful use for specialty practices and healthcare providers in general . . . (Source: EHR Intelligence)

Doctors Administrative Solutions Ranks #795 on the 2012 Inc. 500|5000 Annual Exclusive List of America's Fastest-Growing Private Companies with Three-Year Sales Growth of 430%
(August 21, 2012)Doctors Administrative Solutions (DAS) is pleased to announce Inc. magazine ranked DAS #795 on its sixth annual Inc. 500|5000, an exclusive ranking of the nation's fastest-growing private companies. This positions DAS as the #1 broad-based ambulatory EHR provider on the list . . . (Source: Virtual-Strategy Magazine)

Physician Series: EHR Requirements for OB/GYN
(August 15, 2012) There are plenty of big-time EHR vendors that claim their offering can adhere to the unbending needs of specialty practices as one-size-fits-all solutions. Specialty practices, of course, would be quick to dispute that notion with the argument that the software isn’t specialty-friendly and doesn’t make their documentation easier. So what do these physician look for in an EHR? . . . (Source: EHR Intelligence)

Long Island Medical Supplier Convicted of $10.7 Million Medicare Fraud
(August 15, 2012) The U.S. Attorney for the Eastern District of New York issued the following news release: A federal jury in Central Islip today convicted the owner of a Long Island medical supply company of a $10.7 million Medicare fraud and wrongful disclosure of private patient information. The conviction of Helene Michel of Old Brookville, New York, was announced by Loretta E. Lynch, United States Attorney for the Eastern District of New York, Janice K. Fedarcyk, Assistant Director-in-Charge of the Federal Bureau of Investigation, New York Field Office, and Thomas O'Donnell, Special Agent-in-Charge of Health and Human Services (HHS), Office of the Inspector General (OIG), Office of Investigations, New York . . . (Source:

U.S. Hospital Companies Seen Under Microscope as Costs Targeted
(August 9, 2012) Investors in U.S. hospital companies can expect more scrutiny of billing practices and the medical need for expensive treatments as the federal government faces greater pressure to recoup billions in fraudulent claims, analysts said. HCA Holdings Inc, the largest for-profit hospital operator in the United States, said earlier this week that federal authorities were investigating whether heart procedures performed at some of its facilities were medically necessary . . . (Source: Reuters)

Whistleblower Lawsuit Alleges Florida Hospital Filed Millions in False Claims
(August 8, 2012) A whistle-blower lawsuit based on insider information from a former Florida HospitalOrlando billing employee and a staff physician alleges that seven Adventist Health hospitals in Central Florida have overbilled the federal government for tens of millions of dollars in false or padded medical claims. The suit claims Florida Hospital used improper coding for more than a decade to overbill Medicare, Medicaid and Tricare, all federal government payors . . . (Source: Orlando Sentinel)

Offshore Medical Billing Offers Effective Medical Billing Services to Increase Cash Flow
(August 4, 2012) Complete & cost-effective medical billing services by experienced medical billing company. Offshore Medical Billing, an expert medical billing company, has obtained the popularity for improving practice cash flow, increasing medical claims coding accuracy, and assists each and every practice . . . (Source: The Creative Coast)

EHRs Can Reduce Doctors' Malpractice Claims: Study
(August 3, 2012) When physicians use electronic health records, they're less likely to face malpractice claims, according to a new study published in the Archives of Internal Medicine. Using electronic health records could help doctors face fewer malpractice suits, a study by Harvard Medical School researchers revealed . . . (Source:

Navicure Improves Score in the KLAS 2012 Mid-Term Performance Review Report
(August 2, 2012) Leading Internet claims clearinghouse’s high score and continued record growth in the second quarter of the year based on superior client service. Dodge Communications, a leading Internet-based medical claims clearinghouse for physician practices, today announced that the company received a score of 93.9 out of 100 for clearinghouse services in the KLAS report . . . (Source: FierceHealthIT)

20 Must-follow ICD-10 Tweeters
(July 31, 2012) It can be difficult to navigate through all the information Twitter puts out every second of every day – and there's a lot of it. Too often, the info that we're actually looking for and interested in goes unnoticed because of the deluge of perhaps less-than-valuable (to each of us as individuals and organizations) odds-and-ends demanding our attention . . . (Source: Healthcare Finance News)

Government Signs on Insurers to Fight Healthcare Fraud
(July 26, 2012) President Barack Obama's administration launched a new partnership with private insurance companies, state officials and other stakeholders to scale up efforts to tackle widespread and increasingly sophisticated healthcare fraud. Speaking from the White House at a table surrounded by leaders from many of the country's biggest health insurers, Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder launched the new initiative, which builds on past efforts to root out crimes that cost U.S. taxpayers billions of dollars every year . . . (Source: Chicago Tribune)

Aetna Joins Medical Group as Insurer-Provider Lines Blur
(July 26, 2012) Aetna Inc. (AET), the third-biggest U.S. health plan, will join with the nation’s 10th-largest doctor’s group to sell coverage in Wisconsin, in the latest collaboration to blur the lines between insurers and providers. Aetna and Milwaukee-based Aurora Health Care will form an “accountable care network” pitched at small- and mid-sized businesses, said Aetna Chief Executive Officer Mark Bertolini . . . (Source: Bloomberg)

AMA: Health insurers cut claims errors in half
(June 18, 2012) The American Medical Association’s fifth annual National Health Insurer Report Card shows that the number of medical claims paid incorrectly by the nation’s largest health insurers was cut in half last year, down to 9.5 percent of claims. The result of the drop from the 19.3 error rate reported in 2011 is a saving of $8 billion due to reduction of administrative work needed to reconcile errors . . . (Source: Healthcare Finance News)

Doctors Group Touts Drop in Medical Claims Errors
(June 18, 2012) The American Medical Association (AMA) said Monday that its efforts have cut the number of medical claims paid incorrectly by insurers, resulting in billions of dollars of savings. "The AMA has been working constructively with insurers, and we are encouraged by their response to our concerns regarding errors, inefficiency and waste that take a heavy toll on patients and physicians," AMA Board Chairman Robert M. Wah said in a statement . . . (Source: The Creative Coast)

ONC Looks to Grow the Power of Health Gaming
(June 14, 2012) At Games for Health 2012 on Thursday – amid talk of virtual worlds, avatars, Kinect sensors, biomechanics, social media crowdsourcing and exergaming – a policymaker from the Office of the National Coordinator for Health IT said that gaming is "on the radar of the federal government." Games for Health, currently in its eighth year, is a different kind of health IT conference . . . (Source: Healthcare IT News)

Medical Associations Argue Different Points in the ICD-10 Debate
(May 21, 2012) The American Medical Association (AMA) started a busy week for letter writing. They sort of make the case for a two-year delay of ICD-10 implementation in a comment letter that also calls for a cost benefit study, a search for an alternative for the ICD-10 code sets and a consensus . . . (Source: Government Health IT)