Medical Billing Blog

Stay up to date with the latest revenue cycle news, trends, and policies.

Protecting our Providers: HIPAA Compliance Procedures

By: Gilbert Johnston

A few weeks ago, members of The Valletta Group attended the Healthcare Business Management Association’s (HBMA) Annual Compliance Symposium in Washington D.C. The event featured highly-informative lectures from various experts in the healthcare industry.

Compliance is a rather broad subject. Quite simply, it is the act of abiding by the governing rules and regulations of a particular industry. However, in the revenue cycle management (RCM) industry, certain aspects of compliance command much greater attention. At the forefront of most RCM insiders’ minds is the Healthcare Insurance Portability and Accountability Act (HIPAA) and more specifically, the privacy and security sections of Title II.


Compliance Symposium 2017 Washington D.C.
Gilbert Johnston, Jeff Bolar, and Cal LaGroue of The Valletta Group enjoying the view from the Senate majority leader’s private balcony.

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Should I participate in the Quality Payment Program and MIPS?

By: Cal LaGroue

The following information is provided by the Centers for Medicare & Medicaid Services:

You may have heard that the Centers for Medicare & Medicaid Services (CMS) is reviewing claims and letting practices know which clinicians should take part in the Merit-based Incentive Payment System (MIPS). MIPS is an important part of the new Quality Payment Program.

The Quality Payment Program works to make Medicare better by keeping patients at the center of healthcare while paying clinicians based on their performance. It replaces the Sustainable Growth Rate formula, which threatened clinicians participating in Medicare with potential payment cuts for 13 years. This program combines and streamlines many existing Medicare quality programs. It also gives new ways to improve care delivery by supporting and rewarding clinicians who:

  • Find new ways to engage patients, families, and caregivers.
  • Improve care coordination and population health management.

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Valletta’s Commitment to Compliance

By: The Valletta Group

The Valletta Group is committed to doing all it can to protect its clients’ interests. When it comes to compliance, we are especially vigilant. That’s why we’ll once again be attending HBMA’s Annual Compliance Symposium. Each year, this event presents an opportunity to gain valuable education and insights, as well as an opportunity to discuss relevant issues with industry peers.

HBMA Compliance Event

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Reporting Deadline for PQRS 2016 Data: March 31, 2017

By: Cal LaGroue

We at The Valletta Group want to remind all medical providers that it’s not too late to meet the 2016 reporting deadline for PQRS. In order to avoid a 4-6% reimbursement penalty on Medicare Part B claims in 2018, medical providers must submit certain 2016 PQRS data no later than March 31, 2017.

There are three reporting options to choose from, all of which require providers to submit data on a specific amount of 2016 patient interactions. Providers can choose to report individually or as a group.

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