January 11, 2022

How to Ensure Vendor Compliance at your Health System

Ensuring vendor compliance at your health system may seem like a daunting, impossible task that never ends. You’re not wrong. Managing thousands of vendors and holding them accountable is complex and requires attention to detail and a timely dedication your Procurement and Accounts Payable (AP) staff may not have. The results of not doing so can be catastrophic to your health system’s bottom line, costing the healthcare industry $1.7B* annually. To battle this, your health system must create a comprehensive vendor compliance management policy and process. What to Consider in your Vendor Compliance Process Bring AP and Supply Chain Departments […]
September 24, 2019

What You Don’t Know Can Hurt You: Prevent Overpayments under the False Claims Act

In today’s healthcare landscape, the government funds over two-thirds of all provider costs, totaling over $3.5 trillion annually. Generally, the Center for Medicare and Medicaid Services (CMS) manages the payment of these claims. In an effort to maintain integrity in the current healthcare system, providers are responsible for determining whether the submitted claims are paid correctly. If an overpayment is made, the provider must report and return the funds within 60 days of discovery. Overpayments can occur from duplicated claim submissions, payment for non-covered or excess services, payment to the incorrect individual, or any other misapplication of government funds. 31 […]
June 20, 2018

Managing Your 340B Program

The 340B Drug Discount Program offers qualified hospitals deeply discounted rates on drugs, but many aren’t using the program to its maximum benefit. A 340B pricing analysis from an experienced healthcare auditor can reveal several errors in your drug pricing and prevent you from leaving money on the table. Let’s take a look. 340B Program Challenges Just because your health system is eligible for 340B doesn’t mean it’s a turnkey process. The government and drug manufacturers adjust the pricing guidelines for 340B products every quarter, keeping back-office teams on their toes to update each item’s pricing as needed. That creates […]
May 22, 2018

What Does Explant Monitoring Mean for Hospitals?

From pacemakers to joint replacements, hospitals go through a significant amount of implants in the course of normal business. However, when these implants become explants due to defects or other issues, they can become a liability for the hospital’s Medicare compliance. Let’s break down explant monitoring and why it’s an issue no hospital should overlook. What is explant monitoring? Pacemakers and other implants may need to be removed for several different causes, some of which may be covered under the device’s warranty. If so, the manufacturer will issue a credit to the hospital. In 2007, however, Medicare and Medicaid noticed […]
April 17, 2018

Understanding Health System Tax Errors

With another income tax season in the books, it may be time to look into the other tax liabilities to ensure compliance with all levels of the tax code. A recovery audit for taxes can reveal a variety of breakdowns in your financial processes that carry wide-reaching consequences for your organization’s cash flow. Let’s take a closer look at how your health system is susceptible to errors in tax compliance. What tax liabilities do health systems have? A non-profit health system’s sales and use tax liability vary greatly depending on the state. Some states may exempt only tax on labor, […]
Understanding Health System Tax Errors
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