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Should You Hire An Independent Review Organization (IRO)?

No matter the kind of business you run, you will definitely face competition. How you compare with your competitors when it comes to things like the quality of service you offer is something you may question. This competition is why you should consider hiring an independent review organization (IRO). An independent review organization (IRO) is […]

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Understanding When The Stark Law Applies To Your Healthcare Practice

Physicians have been confused about Stark Law and how it applies to them. Some believe the law applies to all fraud and abuse violations, but it is only relevant when it comes to particular healthcare services and Medicare beneficiaries. The law also applies indirectly to referrals of Medicaid beneficiaries, but for simplicity, we will only […]

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Getting The Most Out Of Your IRO

There are many advantages to sending your medical reviews to an Independent Review Organization (IRO), from faster turnaround times to accessing more specialty knowledge. Once you have made the decision to use an IRO, it is important to have an understanding of how to get the best results. The following tips can help you get […]

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What Is An IRO?

IRO stands for independent review organization. This type of organization is present in many industries, providing peer review and judgement of a person’s work, production, performance, or related behavior. The use of IROs has become a leading practice in the healthcare industry in the past few years. Using an IRO is a great way to […]

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5 Steps That Can Help You Avoid A Qui Tam Lawsuit

The False Claims Act allows the government to recover losses from private entities that overcharge the government for services. The Obama Administration placed a high priority on fighting healthcare fraud, which has led to numerous investigations and large recoveries against the healthcare industry. In 2015, the administration recovered over 3.5 billion dollars. Qui tam is […]

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5 Steps To Help Your Healthcare Practice Stay HIPAA Compliant

Instituting a HIPAA compliance program is only the beginning. Staying HIPAA compliant takes time and commitment. It is critical to review the various departments in your practice and make sure that your policies remain up to date. You may be surprised at how quickly technology evolves and leaves your policies outdated. You may also be […]

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How the Patient Protection and Affordable Care Act Affects Pharmacies

March 21, 2010 was a historic day in American history, as Congress passed legislation entitled “The Patient Protection and Affordable Care Act.” Two days later, President Barack Obama signed the bill into law, providing healthcare to citizens across the United States. Supporters celebrated this first major victory in a long struggle to gain some form […]

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How To Set Up A Pharmacy Compliance Program

Over the years, many pharmacies and pharmacists have been charged with or convicted of Medicare fraud, or for fraud committed on another government program. The truth is that a pharmacy employee can commit fraud too. You may not permit the illegal practice, but if you do not have effective internal controls and compliance programs, then […]

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Why Businesses Need An Employment Litigation Lawyer

Do you have an employment litigation attorney ready to take your call at any time? Employers are required, by law, to follow ever-changing state and federal employment laws. You want to spend your hard earned profits on building your business instead of paying fines or defending lawsuits. An employment litigation lawyer can help you do […]

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What You Need To Know About Medicaid Fraud Control Units

Medicaid fraud costs the American taxpayers millions of dollars every year in fraudulent claims and overcharges. All states are affected by Medicaid fraud. Culprits include large hospitals, pharmacies, medical equipment providers, physician practice groups, and clinics. It is important for everyone in the healthcare industry to understand Medicaid fraud and how Medicaid fraud control units […]

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