Fraud and Abuse

Fraud and abuse in a medical professional environment is a problem that can be avoided with integrity. The CMS is dedicated to fighting fraud and abuse. On February 8, 2006 the CMS' Medicaid Integrity Program was implemented to strengthen State and Federal relationships to ensure the integrity of the Medicaid program. States are responsible for policy fraud, and the CMS provides assistance, guidance, and oversight in there efforts. Since fraud schemes often cross state lines, the CMS is committed to improving information sharing among the Medicaid programs.

Here are some links for more information and for reporting fraud and abuse.


State Program Integrity Support and Assistance
https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/FraudAbuseforProfs/index.html?redirect=/fraudabuseforprofs/

State Contacts
http://www.cms.gov/apps/contacts/

Medicare Fraud - How to Report
http://www.medicare.gov/fraudabuse/howtoreport.asp

OIG - Fraud
http://oig.hhs.gov/fraud/

Medicare Guidance Fraud Prevention
https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/FraudAbuseforProfs/MedicaidGuidance.html

e-Health Code of Ethics

The US National Library of Medicine posted an article on e-Health Code of Ethics. The e-Health Code of Ethics is there to try and ensure that people worldwide can understand the risks and take advantage of the potential in managing there own health when it comes to Internet information.

The site has a vision statement, introduction, definitions, and lists the guiding principals. The guiding principals include: candor, honesty, quality, informed consent, privacy, professionalism in online health care, responsible partnering, and accountability.

Visit this site to learn more:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761853/

Evolve

Once I was registered on the Evolve Website it was much easier to navigate. Before I could register I had to locate the resource for the textbook I am using. How I did that was by entering INSURANCE HANDBOOK FOR THE MEDICAL OFFICE 13TH EDITION into the search bar. I highlighted the free resource link for the text, and then I registered, and redeemed. I filled out the account information to register and I was on my way. I hope this was helpful to anyone having trouble with this Website.

The resources this site offers to accompany the textbook are helpful. It has blank CMS-1500 claim forms, many Medisoft exercises, and it includes addition resources for every chapter in the book. It even has a crossword puzzle for each chapter.

Go ahead and register to begin your Evolve learning. Here is the link:
https://evolve.elsevier.com/

Web Sites

Here are some good web resources:


AAPC
https://www.aapc.com/

CMS
http://www.cms.gov/

Advance for Health Information Professionals
http://health-information.advanceweb.com/

NUCC
http://www.nucc.org/

Evolve
https://evolve.elsevier.com/

HIPPA
http://www.hhs.gov/ocr/privacy/

Department of Health and Human Services
http://www.hhs.gov/

Retire Guide

https://www.retireguide.com/medicare/

https://www.retireguide.com/medicare/supplement-insurance/

https://www.retireguide.com/medicare/coverage/

https://www.retireguide.com/medicare/costs/

Advance for Health Information Professionals (HIM)

Advance Healthcare Network for Health Information Professionals

This Website is extensive, filled with excellent resources and information that can benefit any health information professional. I found it quite easy to create an account and sign up for the free eNewsletter. This site is a great career resource, and it is updated daily. You can post comments, find news bulletins, blogs, and free Webinars.

There is many tabs to links including resources, blogs, columns, education, Webinars, salaries. As well as a ICD-10 tab with much content on ICD-10. At the top of the page they have tabs for professions, jobs, shopping, custom promotions, career events and more.

I really liked the shop tab. It had everything, equipment, accessories, lab coats, scrubs, shoes, and much more.

The career event tab was especially useful with information on conferences, and job fairs both online and in person.

This site contains a high number of informative articles including a wonderful article on steps to prepare for exams. This article has general preparation tips and suggestions. It is set up in a step by step format with recommended study materials with links to find them. Steps, links, and information which could lead you to a successful exam.

I highly recommend checking out this site:

 http://health-information.advanceweb.com/Interstitial/Interstitial.aspx?Id=4&NextPage=/

NUCC

The NUCC or the National Uniform Claim Committee Website is a place to get updated claim forms and updated instructions to fill them out. The site offers announcements about in person meetings, approvals, updates, and more. It has information on the structure of the NUCC and its members. There is a comprehensive calendar of this coming up and where they will be. It has 1500 claim form PDF downloads, instruction manuals, change request forms, and FAQ about them. It provides code sets and provider types, as well as, information for the codes. The tab I found of good use is the Resource Tab. It has links to information, organizations, and committees.

 http://www.nucc.org/

CMS

After checking out the cms.gov Website I found a lot of interesting things I liked about this site.

CMS is the Centers for Medicare & Medicaid Services

• You can read up on the latest news from the CMS
• Get enrollment information
• Get information on Medicare and Medicaid
• Get online manuals
• Find links to outreach and education
• Find your provider type
• and so much more!

Something I really liked was the links to the downloadable PDF's of all the CMS Forms including the CMS-1500 Health Insurance Claim Form.

On the Innovation Center link you can find out where innovation is happening. You can share your ideas. The Innovation Center offers Webinars and Forums about its programs which provide opportunities to learn about current programs, and events. It has a forum to ask questions and make comments.

You can also sign up for email updates from the CMS.

Just go to cms.gov

AAPC

The local chapter of the AAPC meets in Oceanside, CA. There location is Tri-City Medical Center, 4002 Vista Way, Oceanside, CA 92056.

The meetings cost $10, $5 for students. They last one hour. The next meeting is today August 18, 2015 at 6:00 p.m.

This Website is great. They have a lot of information on Medical Coding Training, Certification, Jobs, Education, Networking, and much more.

Here is the link for you to check out:
https://www.aapc.com/localchapters/local-chapter-info.aspx?id=01059774

Introduction

Hello and welcome to my blog.

 

My name is April Ladd

 

My education and career goals are to earn my Associates of Arts degree with a major in Medical Office Specialty. I am also working on my Medical Office Specialist Certificate. I plan on using my degree and certificate to get my foot in the door at a medical office where I can train for the back office. I am more interested in the clinical side of the medical office but I find everything in the medical field interesting. I have a passion for helping people. I was a elderly and disabled Home Health Care Provider for 11 years and believe my path is a natural transition in my career of helping people with there health care needs.

"The future belongs to those who believe in the beauty of their dreams."                                                -Eleanor Roosevelt