SunHawk Consulting, LLC is excited to announce that Directors Kimulet Winzer and Jan Elezian will be featured in the September 2021 issue of the HCCA Compliance Today Magazine! Be sure to pick up your copy of Compliance Today to read their article, Current evaluation methods of telehealth and post-pandemic permanent changes.
Preview the article below, and be sure to visit https://bit.ly/2WvANEs to read their full article for free!
Excerpt from "Current evaluation methods of telehealth and post-pandemic permanent changes"
By Kimulet Winzer and Jan Elezian
Although the use of telehealth is entering into an exciting and imaginative vision, the basics are still applicable, and federal and state telemedicine requirements must be followed. The U.S. Department of Health & Human Services Office of Inspector General has expressed concern that increased access and decreased burden of telehealth services may be compromised by fraud, abuse, or misuse. Therefore, the Office of Inspector General is currently conducting audits to uncover any improper activity. One of its first audits found that “only three percent of the sampled telemedicine payments met federal and state requirements....In 95 percent of the cases reviewed, the providers failed to document the start and stop times and the consulting site location of the medical service.” The Office of Inspector General determined that providers were not formally trained on telemedicine documentation requirements, nor did they adequately monitor compliance.
Compliance professionals can learn from these audits. If your organization offers telehealth services, consider monitoring patient consent to telehealth services, patient consent to electronic communications (e.g., email), documentation and claim information related to duration of service, and documentation related to coding in order to meet federal and state requirements for payment. Virtual health strategies require attention to workforce engagement and developing an infrastructure to support long-term success.
“Copyright 2021 Compliance Today, a publication of the Health Care Compliance Association (HCCA).”
About the Authors
Kimulet Winzer, JD
SunHawk Consulting, LLC
Kimulet Winzer has 25 years of Medicaid managed care experience. She’s worked with healthcare providers, advocates, regulators, payor plans, attorneys, vendors, lobbyists and healthcare leaders on a myriad of operational remediations, innovations and core compliance program development, implementations and training. Most recently she served in a leadership role with UnitedHealthcare as a regional compliance director for the Medicaid program. Prior to her 13 years with UnitedHealthcare she helped to build and implement Medicaid and Medicare DSNP Compliance programs; oversee member and provider grievance and appeal processes and help in the understanding of regulatory changes impacting the delivery of managed Medicaid services and programs.
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Jan Elezian, MS, RHIA, CHC, CHPS
SunHawk Consulting, LLC
Jan Elezian has 40 years of Healthcare consulting experience including Health Information Management (HIM), HIPAA, Meaningful Use, Medicare/Medicaid Coding, Stark/Anti-Kickback, Research and Revenue Cycle compliance. Jan has also served in various administrative roles at integrated health systems and other healthcare providers. Jan is a Certified Healthcare Compliance Professional (CHC), a Certified Healthcare Privacy and Security Professional (CHPS), and a Registered Health Information Administrator (RHIA).
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