Search Results: compliance expert
Common Features Among Corporate Integrity Agreements
The rise in enforcement actions focused on health care fraud by the Department of Justice (DOJ) has led to an…
Corporate Integrity Agreement (CIA) Negotiation Tips
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) is currently monitoring over 300 active Corporate…
Tips and Pointers on Initiating Internal Investigations
Tips and Pointers on Initiating Internal Investigations An organization may call upon a variety of individuals to respond to a…
Claim Processing in Healthcare: Steps for Effectively Monitoring, Billing, and Auditing to Manage Risk
Today, healthcare providers face increasing scrutiny of their claims processing system by regulatory agencies and auditors. Incorporation of claim processing…
Dissecting the Internal Audit Function in Health Care
The traditional role of the internal auditor is to independently and objectively analyze, review, and evaluate existing procedures and activities as well as report…
Internal Audit Services
Health Care Internal Audit Services Health care organizations are drawing intense scrutiny from not only the government but also from…
CMS and OIG Issue Final Rules Revising the EHR Donation Stark Law Exception and Anti-Kickback Statute Safe Harbor.
The Centers for Medicare & Medicaid Services issued a final rule updating certain aspects of the electronic health records (EHR)…
Our Team
Over the last 20 years, Strategic Management has built an organization of expert health care consultants with decades of experience…
Instructions for Part A to Part B Billing for Medicare Denied Inpatient Hospital Claims.
The Centers for Medicare & Medicaid Services (CMS) recently released temporary instructions for billing Medicare Part B services provided during…
Managed Care Advisory Services
Managed Care Industry Experience Strategic Management has been providing compliance-related services to health insurance plans and managed care organizations (MCOs)…
Deficit Reduction Act Mandates Education on Fraud and Whistleblowers
On February 8, 2006, the Deficit Reduction Act of 2005 (DRA) was signed into law. Chapter 3 of Title VI specifically focuses…
When and How Should a Hotline Vendor be Re-Evaluated?
Most healthcare organizations have been using the same hotline vendor for many years. Over time, advanced technology and enhanced methodologies…