Preparing for RADV Audits: Key Considerations for Health Plans
By Jeannie HennumGeneral Manager, Value Based CareVerismaJune 24, 2025My esteemed colleague and government affairs/policy guru Elizabeth McElhiney recently published a blog for providers detailing an announcement from the Centers for Medicare and Medicaid Services...
Preparing for RADV Audits: Key Considerations for Health Plans
RADV audits are important to the entire healthcare system – safeguarding the accuracy and integrity of health plan data, and the effort is part of the federal government’s effort to remove fraud, waste and abuse (FWA) in Medicare Advantage (MA) programs.
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Best Practices for Managing Mental/Behavioral Health Records/Psychotherapy Notes
Under Health Insurance Portability and Accountability Act (HIPAA) Privacy Law, there’s a distinction between mental health records, part of a patient’s overall medical record, and psychotherapy notes, which are provided special consideration to be separate pieces of information.
Interoperability Challenges in the Pursuit of Patient Access
During a recent panel, healthcare professionals looked at and discussed patient access from three perspectives: health information management, patient, and patient advocate.
Can TEFCA Get Us to True Interoperability?
By January 2026, all certified electronic health record (EHR) users must comply and exchange information per the Trusted Exchange Framework Common Agreement (TEFCA).
What HI Professionals Can Expect in 2024
By Elizabeth McElhiney, MHA, CHPS, CPHIMS, CRIS Director of Compliance and Government Affairs Verisma January 2, 2023Privacy gets (more) complicated We’ve said it before – the US is overdue for a national conversation on privacy. 2023 only increased the stakes with...
Recap on Recent Regulatory Announcements
While there were multiple regulatory announcements in the news this week, we’ll recap the President’s Executive Order on AI and ONC’s proposed rule on appropriate provider disincentives.
Top Reasons to Optimize Payer Audit Management
In today’s ever-evolving healthcare landscape, navigating the challenges posed by increasing payer audits and denials demands a proactive and expertly crafted approach to claims accuracy and compliance.
Overcoming Staffing Challenges in Healthcare Information Leadership
In my role as the CHIA President-elect, I had the privilege of addressing our California members on a pressing topic that resonates with healthcare information leaders across the industry.
Five Ways an FQHC Can Save on Administrative Costs
Federally Qualified Health Centers (FQHCs) provide critical care for underserved patients nationwide, but on a limited budget supported mostly by donations and grant funding. By focusing on decreasing administrative costs, FQHCs can make their dollars more impactful...
How Leveraging an HIM Partner Helps Decrease Staff Stress
“Everything Everywhere All at Once” isn’t just the title of an award-winning movie that many viewers found quite confusing. It’s how a lot of health information management (HIM) employees feel about their jobs. There aren’t enough hours in the day, and one person...
How to Use a Gap Analysis to Build Your ROI Roadmap
One of the best tools for ensuring organization-wide ROI compliance is a gap analysis. A gap analysis looks at the entire disclosure management process to give you a sense of where you are today versus where you need to be to achieve and maintain compliance. In...