FWA Briefs

The Centers for Medicare & Medicaid Services (CMS) recently released new guidance that may affect certain providers wanting to obtain an NPI if they don’t already have one. These guidelines are important for you and your health plan to have protection against fraud, waste, or abuse (FWA) in your claims.

Available to VBA subscribers today, this solution provides real-time Medicare Prospective Payment System (PPS) pricing during claims processing. Direct PPS pricing ensures compliance with the Centers for Medicare and Medicaid Services (CMS). It eliminates complexity and the need to utilize less accurate substitutes like RBRVS.

The recent Department of Justice (DOJ) $155 million False Claims Act settlement with eClinicalWorks highlights a problem that has existed in the EHR software industry for a long time.  Any EHR system that attests to do everything for the integrated health system can’t possibly provide the highest possible level of all aspects of functionality.  Some parts of the system will be concentrated upon while others will get just enough attention so the vendor can say they have the ...