Outpatient Facility Coding Alert - 2019 Issue 5
Physician Notes: CMS Gets In on the HIPAA-Audit Game
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Article Overview
This piece explains two CMS-related updates for providers and compliance staff: a new HIPAA-focused compliance review effort involving electronic health care transactions, and the annual Medicare Administrative Contractor satisfaction survey. It is relevant for organizations that submit electronic transactions, monitor administrative simplification requirements, or track CMS provider outreach and contractor performance programs.
Why This Topic Matters
Providers and billing organizations may need to understand how CMS is expanding compliance review activity and how to participate in or monitor CMS feedback programs. The article also helps readers distinguish between the different Medicare contractor types referenced in the survey discussion.
Article Sections
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Compliance Review Program
Overview of CMS’s new compliance review effort and the broader HIPAA administrative simplification context. Covers provider participation, electronic transaction review, and program timing at a high level.
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MAC Satisfaction Indicator survey
Discusses the annual CMS survey for Medicare providers to evaluate their Medicare Administrative Contractor. Also notes the survey’s limited scope and related contractor categories referenced by CMS.
What You Will Learn
- How CMS is expanding its compliance review activities related to electronic health care transactions
- What the CMS provider pilot program is intended to address at a general level
- What the MAC Satisfaction Indicator survey is and who it is intended for
- How CMS positions provider feedback on Medicare Administrative Contractors
- Which broad CMS contractor types are mentioned as outside the survey’s scope
Who Should Read This
- Physician practices
- Billing and coding professionals
- Compliance officers
- Health care administrators
- Medicare providers
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