Search Results: compliance expert
OIG 2019 Report on Fraud Actions and Recoveries
Key Points: $3.6 billion recovered 528 DOJ criminal convictions 747 OIG criminal actions 2,640 new exclusions In June 2020, the…
Nursing Facilities Heading Toward Enforcement “Perfect Storm”
Tom Herrmann, JD, is a recognized expert on nursing home compliance. When asked about the state of legal and regulatory…
HIPAA Frequently Asked Questions
HIPAA Compliance Overview Listed below are frequently asked questions about HIPAA compliance requirements. Browse this resource for the basics of…
FAQs About OIG Corporate Integrity Agreements and Independent Review Organizations
Listed below are several frequently asked questions about the roles of Independent Review Organizations (IROs) and OIG Corporate Integrity Agreements…
80% of HIPAA Privacy Officers Report to the CEO or CO
Results of the 2019 HIPAA Compliance Benchmark Survey to be presented at our upcoming free webinar More than 300 organizations participated…
Revenue Integrity Advisory Services
Federal and state law enforcement and regulatory agencies routinely request information from health care organizations. There are numerous reasons for such requests that range from routine claims monitoring activities, audits by Medicare Administrative Contractors, fraud investigations by Medicare Integrity Contractors, or even investigations by the Department of Justice. Strategic Management’s consultants work side-by-side our clients to assist them in responding promptly and effectively to meet the scope of the government’s request.
Healthcare Claims Auditing & Monitoring
Auditing and monitoring the claims development and submission process is critical for any health care organization. Through effective claims auditing and monitoring, health care organizations can identify risk, and implement controls to manage these risks. Strategic Management employs a systemic approach to auditing and monitoring that is tailored to the uniqueness of each organization we work with.
Billing & Coding
The accuracy of a health care organization’s billing and coding is critical for receiving appropriate reimbursement on items and services rendered by their health care professionals. Federal health care program payors issue guidance and billing rules that health care organizations must comply with. Strategic Management assists health care organizations in understanding these billing and coding rules, and further assists with implementation of policies and procedures to help sustain long-term compliance.
Healthcare Claims Data Analysis
Strategic Management’s health care claims data analysis and review services enable health care providers to identify trends in their data, analyze claims for reimbursement and implement improved billing and coding procedures. Our experienced consultants and claims auditors are the nation’s leading experts in data analysis using RAT-STATS statistical sampling.
Investigations & Remediations
Strategic Management is a leading expert in conducting privacy and security related investigations for health care organizations. Our expert investigators perform objective, professional and in-depth investigations and further assist with developing and implementing actions to remediate non-compliant areas.
Privacy Program Design & Implementation
Strategic Management designs and implements HIPAA Privacy Programs that address the unique needs of organizations, while meeting the standards and expectations set forth by OCR and the HIPAA Privacy Rule. We have the expertise to successfully implement an effective HIPAA Privacy Program in all types of healthcare organizations, ranging from physician practices, SNFs, home health and hospice, managed care organizations, academic medical centers, hospitals and health systems.
Regulatory Due Diligence – Critical for Healthcare Mergers and Acquisitions
Companies see tremendous return on investment (ROI) for employing the right experts Mergers and Acquisitions (M&A) are taking place at…