Today, healthcare providers face more regulations than ever. One particular form of regulation that has become more common in the past decade are Zone Program Integrity Contractor (ZPIC) audits.These audits were designed to enforce Medicare regulations and deter...
Texas Health Care Law Blog
Managing difficult patients without risking your license
Whether due to a hostile attitude, refusal to follow medical advice, anger over a diagnosis or more, many doctors, nurses and other health care professionals have encountered difficult patients at some point. Dealing with these individuals can be complicated,...
What to do if Medicare sends you too much money
It happens sometimes – you file a claim with Medicare and because of insufficient documentation, duplicate payments or administrative errors, you get paid too much money.What happens next? Medicare usually asks you to pay the money back. But you do have options....
The lengthy reinstatement process for nurse licensing
Licensed nurses rely on their accreditation for their living. If your license is revoked, Texas has a lengthy reinstatement process for you to undergo before you can work as a nurse again.The reinstatement process includes these steps before you’re able to work...
What if you suspect fraudulent activity at your own practice?
Physicians rely on the trust of multiple people, including patients, employees and members of the public. Unfortunately, some unscrupulous doctors abuse this trust to commit acts of fraud. However, there is sometimes a gray area where a trustworthy physician...
Actions that will threaten a medical career
A suspension or revocation of a medical license is one of the biggest threats to a doctor, nurse or other medical professional’s career. It may seem difficult to believe, but even after spending years striving toward their goal, many individuals in the medical...
How to prepare for a ZPIC audit
During the course of regular business, durable medical equipment (DME) providers may face audits from zone program integrity contractors (ZPICs) working under Medicare and Medicaid. These audits are meant to root out fraudulent activities. Being selected for an audit...
Pharmacists can finally talk freely about drug prices
In the United States, where prescription drugs are not price-regulated by one, powerful agency, such as the federal government, smaller insurance companies must negotiate with these large drug makers. What the drug makers have found is, they have the upper hand. As...
Diligence in claim filing can reduce medical audit anxiety
Who doesn't like taking shortcuts. If there is a way to get from point A to point B more easily, that's a good thing, right? That might be true in on the road, but in the health care industry, taking shortcuts around regulatory obligations can lead to financial...
National Provider Identifiers can be stolen and used for fraud
National Provider Identifiers (NPI) are used to help streamline the medical billing process, and these 10-digit numbers function much like a social security number.Unfortunately, like a social security number, a NPI is also vulnerable to theft. This is because NPI are...