Sep 1, 2023 | Healthcare Compliance
SunHawk Consulting, LLC is excited to announce that Managing Director, James Rose will be presenting at the 2023 September Auditing & Monitoring Conference on September 6, 2023 The presentation will be a case study on AUDITING CONTROLS VERSUS TRANSACTIONS You Will...
Aug 23, 2023 | Healthcare Compliance
SunHawk Consulting, LLC is excited to announce that Lorraine Aniello and Leah Lane will be presenting on the topic of “A Healthcare Study in Fraud and Collaboration with Clinical and Medical Coding Teams” at the Clinical Practice Compliance Conference,...
Jul 13, 2023 | Healthcare Compliance
In our previous article, we explained how Risk Adjustment is a “partnership” between the patient, the provider, the insurance plan (Plan), and the governmental entity. So, which partner in this process holds the “risk”? Governmental Entity: The governmental entity has...
Jul 5, 2023 | Healthcare Compliance
Under the risk adjustment (RA) model, reimbursements to the insurance companies (Plans) are based on the member’s level of severity of illness rather than the number and types of interventions the member receives throughout the year. This reimbursement model is based...
May 2, 2023 | Healthcare Compliance
This article, as part of the SunHawk Consulting team’s Medical Risk Adjustment compliance as well as statistical sampling & coding audit services, gives a high level overview of some upcoming changes for 2024 in the CMS Risk Adjustment model, V28. The CMS-HCC Risk...
Apr 7, 2023 | Healthcare Compliance
Interested in advancing your audit skills and developing an audit engagement scope? SunHawk Managing Director James Rose, along with Sara E. Coverstone, Chief Compliance & Privacy Officer, Northern Arizona Healthcare, are presenting later this month at HCCA...
Apr 3, 2023 | Healthcare Compliance
As the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) continues to ramp up its enforcement efforts, SunHawk Consulting had prepared a summary report to help organizations stay informed of the latest trends in Corporate Integrity...
Mar 24, 2023 | Healthcare Compliance
The NetSmart myAvatar platform provides a modern physical and behavioral health electronic health (EHR) record solution. As with all EHR implementations, there is a lot to consider before upgrading your environment, including how much of the heavy lift of the...
Feb 27, 2023 | Healthcare Compliance
The February 2023 issue of the SCCE Compliance and Ethics Professional (CEP) Magazine is featuring one of our Directors, Scott Moritz, with an article on How to get the most out of your confidential hotline. Preview the article below and click HERE to read the full...
Feb 23, 2023 | Healthcare Compliance
The United States Government requires Corporate Integrity Agreements (CIA) for health care Providers, Payers and Life Science companies when settling allegations of false claims related to quality of care or corporate integrity issues, against various Federal health...
Feb 6, 2023 | Healthcare Compliance
SunHawk Consulting, LLC is excited to announce that Managing Director, James Rose will be co-presenting at the General Audit and Monitoring Conference on March 14th! Don’t miss out on his presentation on Exploring the Standards- Managing Internal Audit and...
Jan 30, 2023 | Healthcare Compliance
SunHawk Consulting, LLC is excited to announce that Managing Director, James Rose will be presenting at the SCCE’s Aerospace, Defense & Government Contracting Compliance & Ethics Conference on February 21st! Don’t miss out on his presentation on...
Jan 20, 2023 | Healthcare Compliance
Managing Director, James Rose will be presenting on Establishing an Enterprise ERM/GRC Strategy with Compliance in Mind at the HCCA Managed Care Compliance Conference on January 31st through February 2nd, 2023! Click HERE to register for the HCCA Scottsdale...
Dec 20, 2022 | Healthcare Compliance
HHS OIG Office of Audit Services and Office of Evaluation and Inspections issues approximately 300 audits and evaluations a year. The findings and recommendations provided herein are extracted from the specific audits included in this report and referenced by their...
Oct 26, 2022 | Corporate Compliance, Healthcare Compliance
SunHawk Consulting, LLC is excited to announce that Managing Director, James Rose will be presenting at the HCCA Scottsdale Regional Healthcare Compliance Conference on November 4th, 2022! Don’t miss out on his presentation on Establishing an Enterprise ERM/GRC...
