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Question: Our practice is fairly new, and we are in the process of developing internal processes to follow going forward.What is the purpose of an audit and how can that help our practice?

Answer: An internal medical coding and billing audit is a process that examines and evaluates the effectiveness and reliability of clinical documentation and the overall medical billing process. This process thoroughly checks health records maintained by the practice and reviews medical billing data submitted to the payors to help ensure that the practice identifies, monitors and corrects inappropriate billing practices.

When going through a coding and billing audit, the auditor collects clinical records, which may include medical records, x-rays, and lab reports; financial records such as entered charges, explanation of benefits (EOBs), and accounts receivable ledger; and policy-related documentation as required by providers or the government.

Audits can be conducted either before claims are sent out to the payors (prospective) or after the fact (retrospective). Some practices follow the rule of conducting new provider audits prospectively, and current provider audits retrospectively.

Scope of Medical Billing Audit

Medical billing audits have a more comprehensive approach than coding audits. Medical billing audits cover all the areas of the medical billing life cycle starting from insurance verification processes, ICD-10-CM and CPT coding, claim submission, payment posting, follow-up, and denial management processes.

Advantages of Medical Billing Audit

Coding compliance: Billing audits provide a way to identify and correct problem spots before the government or insurance payors challenge inappropriate coding. You can rely on billing audits for identifying inaccuracies, providing instructions on ways to correct issues, building confidence among the coding staff, and ensuring to use of up-to-date procedure and diagnosis codes. Those conducting the audit can identify areas where staff education and training are needed to make sure that proper coding protocol isfollowed.

Administrative Benefits: The administrative staff benefits from medical billing audits by confirming that claims are true and accurate and are correctly submitted. Audits set the standard for the office staff and spare them unnecessary frustration by creating a positive, stable work environment and culture of compliance that attracts and retains talented personnel. Under- and over-coding, code overuse, and improper unbundling habits are replaced with appropriate billing for services and procedures. When policies and procedures are set in place and followed correctly, the chance of a visit from an external auditor decreases significantly.

Ensure compliance: Through medical claims audits, the practice can help protected itself against fraudulent billing activity and claims. The audit may identify reimbursement deficiencies and reveal ways in which the practice varies from the national average due to inappropriate coding. Areas for increased reimbursement may be revealed and, in turn, boost revenue. Additionally, the practice benefits when files are processed efficiently, improper payments are reduced and claim payment is optimized.

ReneeDowling is a compliance auditor for Sansum Clinic, LLC, in Santa Barbara, California.

Link:
What is a medical coding and billing audit? - Medical Economics

On the morning of 25 August 2014, a 16-year-old girl arrived at the University of Texas Southwestern Medical Center in a baffling condition. She was short of breath but had no chest pain. She had no history of any lung condition and no abnormal sounds in her breathing. But when the emergency room doctor on duty pressed on her neck and chest, he heard noises like Rice Krispies crackling in a bowl of milk. Spaces behind her throat, around her heart and between her lungs and chest wall were studded with pockets of air, an X-ray confirmed, and her lungs were very slightly collapsed.

The doctors were confused until she said that shed been screaming for hours the night before at the Dallas stop on One Directions Where We Are Tour. The exertion, they hypothesised, had forced open a small hole in her respiratory tract. It wasnt really a big deal she was given extra oxygen and kept overnight for observation and she required no follow-up treatment. But the incident was described in all its absurd, gory detail in a paper published in the Journal of Emergency Medicine three years later. The lead physician wrote that such a case had yet to be described in the medical literature. Doctors were familiar with military pilots, scuba divers and weightlifters straining their respiratory tract, but this case presented the first evidence that forceful screaming during pop concerts could have the same physical toll.This was a novelty news item: an easy headline and a culturally salient joke about the overzealousness of teenage girls. It was parody made real and recorded with the deepest of seriousness, for all time, in a medical journal. I know nothing else about the girl who loved One Direction so much that she collapsed her lungs over it. Her doctor wrote to me that hed asked, at the time, for her permission to tweet at TV host Jimmy Fallon about the incident hed argued that maybe she would get to meet One Direction. But she was too bashful!!!! Classic teenager, he said, adding a laugh-crying emoji.

Ill never know who she is or hear her personal explanation of what made her scream so much. In this specific circumstance, thats because of medical privacy laws, which are good. But its also emblematic of a bigger lack: we have seen so many screaming girls. Every time we see them, were like, Theyre screaming. And thats it. Yet the screaming fan doesnt scream for nothing and screaming isnt all the fan is doing. It never has been.

At Harryween, Harry Styless fancy dress party at Madison Square Garden last year, fewer girls dressed to impress in the fancy sense than in the meme sense, signalling fandom knowledge of in-jokes and stories more than a desire to look attractive. My sister dressed as Harry Styles working in a bakery in England in the 00s, while I dressed as the shrine that one fan erected at the site where Styles vomited beside the 101 freeway in Los Angeles in 2014. Of course, part of my costume was confiscated by arena security because if you let one piece of posterboard into the arena youll end up letting a chaotic amount of posterboard into the arena and no one will be able to see the show.

Reports about screaming girl fans like those from Styless current tour, which kicked off last week in Glasgow have rarely, if ever, noticed these kind of subtleties. When the Beatles visited Dublin for the first time, in 1963, the New York Times reported that young limbs snapped like twigs in a tremendous free-for-all. When they arrived in New York City in February 1964 a little more than a month into the US-radio-chart reign of I Want to Hold Your Hand there were 4,000 fans (and 100 cops) waiting at the airport and reports of a wild-eyed mob in front of the Plaza Hotel.

Nearly all of the writing about the Beatles in mainstream American publications was done by established white male journalists. Al Aronowitz, the rock critic best known for introducing the Beatles to Bob Dylan and to marijuana (simultaneously) in the summer of 1964, reported that 2,000 fans mobbed the locked metal gates of Union Station when the Beatles performed in Washington DC. Then, when the Beatles came to Miami, 7,000 teenagers created a four-mile-long traffic jam at the airport and fans shattered 23 windows and a plateglass door. A plateglass door!

Being a fan is very much associated with feminine excess, with working-class people, people of colour, people whose emotions are seen as being out of control, Allison McCracken, an associate professor and director of the American-studies programme at DePaul University, told me. Everything is set up against this idea of white straight masculinity, where the emotions are in control and the body is in control.

McCracken is an expert on the history of the crooner in American culture and her 2015 book, Real Men Dont Sing, credits Rudy Valle and Bing Crosby with making the blueprint for a pop sensation in the late 1920s and early 30s. McCracken visited the American Radio Archives, in Thousand Oaks, California, to see Valles personal archive of fan letters, dating back to 1928. She was fascinated by the way the women who were writing to him were surprised by their own emotional reactions to his music and were confused by the idea of falling in love with a voice theyd heard only over the radio. They were responding to his voice and saying, I dont understand why Im so happy and joyous and why youre moving me so much, she said. They were writing to him and saying, Can you explain whats happening to me?

Though psychologists had in the early 1900s started describing adolescence as a unique stage of life, the word teenager itself wasnt widely used until the late 1940s, McCracken explained, and the most eager speakers of the term were also marketers. They realised in the postwar boom years that far fewer kids were dropping out of school to earn money for their families and that far more were being given allowances and plenty of leisure time. The 1950s and 60s saw more and more products marketed explicitly to teenagers, often reinforcing the idea that they were a distinct group of people with a separate identity from their parents and with the rise of teen-marketed products came teen-oriented TV shows during which they could be advertised.

So long as teens existed as a lucrative market category, the industry would supply them with a teenybopper idol. When these idols were written about by journalists and critics, it was often with full acquiescence to their marketing, tinged with disdain. This was the case as recently as 2010, when the idol was Justin Bieber. When he performed his first sold-out show at Madison Square Garden that September, the New York Times music critic Jon Caramanica titled his review Send in the Heart-throbs, Cue the Shrieks and wrote that Bieber teased the crowd with flashes of direct emotional manipulation.

Two years later, One Direction were battling Bieber for the No 1 spot on the US charts, and in the hearts of American teenagers, and Caramanica started reviewing the bands output with equal attentiveness. He called their 2012 second album, Take Me Home, a reliable shriek-inducer in girls who have not yet decided that shrieking doesnt become them. He panned the bands 2013 album, Midnight Memories, writing: They play the part almost resentfully, with the mien of people who know better Whether this is transparent to the squealers who make up their fanbase is tough to tell.

This idea that fans are an amorphous mass and that culture is something that happens to all of them in the same way can be traced back to Theodor Adorno, whose 1938 essay, cited in the New York Timess coverage of Beatlemania, described fans at live music performances as empty vessels: Their ecstasy is without content. Adornos work has been the starting point for the past 70 years of pop culture analysis, perhaps right up until the 1990s when cultural historian Daniel Cavicchi spent three years interviewing Bruce Springsteen fans about where their love of Bruce had come from and how it had coloured their lives for his book Tramps Like Us. At the time it was still up for serious debate whether the adoration of a pop star turned a person into an idiot. The cultural anxiety around popular culture then which has relaxed now, even if it hasnt totally disappeared was that it was a homogenising force that turned every participant into a mindless consumer. But in speaking to hundreds of fans, Cavicchi found something different. These people were exploiting the ultra-popular things they loved in order to become more completely themselves. Springsteen fans do not indicate that popular culture is shaping their identity but rather that they are shaping their identity with popular culture, he wrote.

What many commentators couldnt or wouldnt see was that fans have not just passively enjoyed or loudly desired the objects of their fandom. Theyve also edited them and recirculated them and used them as the inspiration for a range of creative works on and offline. The art, the stories, the fan fiction and the in-jokes are as much a part of what it means to be a fan as staking out an airport or memorising dozens of songs. Fans transform their own image by playing with expectations and flouting the rules; dress themselves up in the spirit of Harry Styles indulging in elaborate cosplay as an expression of devotion that is also a prolonged creative exercise. When Styles started wearing blouses and pearls and high-waisted trousers, so did they. They bought old-school rocker platform boots or knitted their own sweaters in the styles of his expensive, designer ones and expressed their fandom through aesthetic iteration.

Theres something else the critics didnt realise: fan girls are funny. In 1964, a group of girls in Encino, California, founded an organisation they called Beatlesaniacs Ltd. It was advertised as group therapy and offered withdrawal literature for fans of the Beatles who felt that their emotions had got out of hand. In a 1964 issue of Life magazine, the group is covered credulously. (The spread on Beatlemania features a full-page image of a girl kneeling on the ground, grass clenched in her hand, tears streaming down her face whether or not she was actually thinking, Ringo! Ringo walked on this grass!, that is how the photo is captioned.) The club is mentioned in a small sidebar, entitled How to Kick the Beatle Habit. What Beatlesaniacs Ltd offers is group therapy and withdrawal literature, it reads. Its membership card immediately identifies the bearer as someone who needs help.

The club was obviously a joke. Its rules included such items as Do not mention the word Beatles (or beetles), Do not mention the word England. But nobody is primed to see self-critique or sarcasm in fans. Seeing them toy with their own image or recognise their own condition contradicts the popular image that has circulated for the past 100 or so years.

Take the story of the shrine to Harry Styless vomit. The facts are these: in October 2014, Styles went to a party at the British pop singer Lily Allens house in Los Angeles. The next morning, riding in a chauffeured Audi, in his gym clothes, on the way back from a very long hike, he requested that the driver pull over. On the side of the 101 freeway, just outside Calabasas, he threw up near a metal barrier, looked up and locked eyes with a camera.

The day they were taken, the photos circulated in tabloids and online, and a few hours later, a Los Angeles-based 18-year-old named Gabrielle Kopera set out to find the spot and label it for posterity. She taped a piece of posterboard to the barrier: Harry Styles threw-up here 10-12-14, she wrote in big letters. The grainy photo she posted first to her own Instagram circled the globe. It is referenced in articles about the moment Harry Styles knew hed made it, which was supposedly the moment someone told him his vomit had been scooped off the ground and was up for sale on eBay.

At the time she took the shot, Kopera was bored: she didnt have the money for a four-year university course so shed stayed home to work and to study at a local community college while most of her friends moved away. Being a fan of Styles and One Direction made her feel as if she had something to do that wasnt a chore.

She was surprised and confused by the way her photo was covered in the media, as if it was something more bizarre than a comedy routine she was performing, primarily with herself as the audience. It was more a joke about my life than his, she told me.

By the end of One Direction, the medias treatment of the bands music and its fans had changed significantly. In part, this was because of a rise in the estimation of pop music among critics and a new focus among content makers on womens websites for celebrating almost everything any girl did as inspiring and empowering. Guilty pleasures were to be enjoyed, not insulted, and it was rude to call them guilty pleasures at all. It is inappropriate now to make fun of girls for screaming or boybands for existing or anybody for liking anything.

You could argue Harry Styles helped drive this cultural change when he appeared in spring 2017 on the cover of Rolling Stone, interviewed by the music journalist and Almost Famous writer-director Cameron Crowe. Whos to say that young girls who like pop music short for popular, right? have worse musical taste than a 30-year-old hipster guy? Thats not up to you to say, he told Crowe. Young girls like the Beatles. You gonna tell me theyre not serious? How can you say young girls dont get it? Theyre our future. Our future doctors, lawyers, mothers, presidents, they kind of keep the world going. He really went for it. Teenage-girl fans they dont lie. If they like you, theyre there. They dont act too cool. They like you and they tell you. Which is sick.

Im happy that he said that, because I know it meant something important to a lot of people. But its hard to celebrate the fangirls coming of age the way Id like to, because it is also being celebrated by the sort of people who will use it to make more money out of us. And its being celebrated by well-meaning people in sort of embarrassing ways as if liking a boyband is a radical political act, the same way wearing well-designed T-shirts with punchy slogans on them is a sincere expression of feminism and Pantone creating a shade of red called Period is empowering for anyone who menstruates. Not all women are our future doctors, lawyers, mothers, presidents, I would love to tell Harry Styles. Not all women keep the world going!

But alongside the overenthusiastic acceptance lies an essential truth: the little indignities and the big disappointments of being young, of not finding the love you want or of not becoming the person youd hoped these things are tempered by fandom. Fandom is an interruption; its as simple as enjoying something for no reason and its as complicated as growing up. It should be celebrated for what it can provide in individual lives. What this is, exactly, is hard to know if you dont bother to ask. Its generally much more than a scream.

Kaitlyn Tiffany is a writer at the Atlantic. This is an edited extract from her book Everything I Need I Get from You: How Fangirls Created the Internet as We Know It, published by Farrar, Straus and Giroux (13.99). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply

Read more:
The truth about screaming fangirls | Pop and rock - The Guardian

In this in-depth interview with Matt Palumbo, author of The Man Behind the Curtain: Inside the Secret Network of George Soros, he discusses the origins of billionaire George Soros and his rise to power as the shadowy figure thats seemingly pulling the strings behind the scenes in American politics. Palumbo describes the purpose of his book as an opportunity to demystify Soros through extensive documentation of his financial sway across multiple spheres of influence in western society.

Palumbo also touches on the inner workings of Soross Open Society Foundation, the interconnected web of foundations and charitable organizations from which most of his philanthropic endeavors are launched. Palumbo provides a few examples from the hundreds of organizations George Soros has contributed to that are listed in his book (Black Lives Matter, Acorn, Defund the Police) as well as a detailed list of media publications that are heavily subsidized by Soros funds.

Our conversation turns towards Soross recent push to promote radically liberal district attorneys and its ramifications on law and order in America, Soross role in the 2020 presidential election, along with his efforts to fund liberal colleges and universities throughout the country.

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Excerpt from:
How Soros Spent $18B to Control the Media, Defund the Police, and Elect Liberal Prosecutors - The Epoch Times

Fifteen vulnerabilities affecting Siemens SINEC network management system (NMS) were unveiled this week, according to new research published by security company Claroty.

The bugs affect all versions before V1.0 SP2 Update 1 and Siemens urged users to update their versions as soon as possible.

Noam Moshe, vulnerability researcher with Claroty, told The Record that the most concerning of the 15 vulnerabilities which include denial-of-service attacks, credential leaks, and remote code execution in certain circumstances revolve around CVE-2021-33723 and CVE-2021-33722.

Moshe noted that network management systems are used to centrally monitor, manage, and configure industrial networks with tens of thousands of devices. They are used widely in industrial automation across several industries, including manufacturing, oil and gas, electrical grids, and more.

Most concerning is the chaining of CVE-2021-33723 and CVE-2021-33722, which creates a powerful exploit that could give an attacker elevated permissions on the SINEC system to NT AUTHORITYSYSTEM, full system access, Moshe said.

From there, an attacker could remotely execute code and also compromise other Siemens devices on the network managed by SINEC.

In a report on the vulnerabilities, Claroty showed how CVE-2021-33723 can be used to gain administrative access and CVE-2021-33722 can then be exploited to instigate a breach.

Siemens SINEC is an NMS built for OT networks and designed for centrally monitoring, managing, and configuring Siemens devices. The SINEC system is configured with all the necessary credentials for the devices in the network so it can communicate, monitor and eventually control the remote devices in the network.

Operators use SINEC to perform firmware upgrades or query the status of remote devices in the network from network switches to Siemens PLCs. It is also used to control and maintain other ICS related equipment.

From an attackers perspective, conquering the NMS is key to getting a strong foothold in the network, Moshe explained.

This is because the attacker could use the normal NMS functionality to take control over network devices by changing firmwares, shutting down remote devices, or even moving across the network while hacking the same remote devices that the SINEC system manages.

Some of the other vulnerabilities discovered, like CVE-2021-33727, authenticate an attacker so they can download the profile of any user, allowing them to leak confidential information. CVE-2021-33733 gives attackers the ability to execute arbitrary commands in the local database by sending crafted requests to the webserver of the affected application.

Other industrial control security experts agreed with Moshes assessment that CVE-2021-33723 and CVE-2021-33722 are the most concerning of the 15 vulnerabilities.

Nozomi Networks Roya Gordon said the two bugs are worrying because they are the beginning of the chain of vulnerabilities in which successful exploitation of the two CVEs allows for the exploitation of the other 13 CVEs.

I will say that whenever you see a blog announcing a vulnerability and it includes the vendor advisory, thats a good sign. It means that there is a fix you can implement right away to prevent all possible exploits, Gordon said.

These vulnerabilities allow a threat actor to gain admin rights to the system and pretty much do whatever they want. They can even Live off the Land, which is a technique threat actors use to erase their steps, making it difficult for IR responders to trace their activity. This also makes it easier for the attacker to remain in the system undetected before even executing an attack, because they appear to be a privileged user. A threat actor with admin capabilities lurking in an OT environment is very alarming.

Ron Fabela, CTO of SynSaber, told The Record that the core vulnerabilities are in not only the control system applications themselves, but also with those subsystems that manage them.

If an adversary has network access to industrial control systems, they often do not need to exploit vulnerabilities in order to impact or disrupt operations, Fabela explained.

Fabela added that the NMS in this case could be a treasure trove of information and control, undoing network segmentation that may be in place and allowing deeper infiltration of the control system network.

Jonathan has worked across the globe as a journalist since 2014. Before moving back to New York City, he worked for news outlets in South Africa, Jordan and Cambodia. He previously covered cybersecurity at ZDNet and TechRepublic.

Originally posted here:
15 vulnerabilities discovered in Siemens industrial control management system - The Record by Recorded Future

Brazzaville The World Health Organization (WHO) welcomes the continental drive to strengthen the architecture of pandemic preparedness and response in Africa. This is critical for protecting and saving African lives as evidenced by the COVID-19 pandemic.

WHO fully supports the ongoing process led by the Africa Union to strengthen the Africa Centre for Disease Control and Prevention (Africa CDC) and applauds its elevation to an autonomousbody.

WHO welcomes the ongoing discussion led by the Africa CDC on a potential continental pandemic declarationmechanism.It is important to assess the benefits and the risks for African Member States. Such a mechanism could reduce Africas dependence on others but could also trigger more travel and trade restrictions and isolate the continent as occurred with the emergence of the Omicron variant of the COVID-19 virus.

Fifty-four African Member States are also currently contributing to the new global architecture for health emergency preparedness, response and resilience led by WHO. Given increasing global interconnectivity, which we have seen with COVID-19, this negotiation will determine how Africa will be protected from outbreaks arising elsewhere and how to manage health emergencies originating in Africa.

Concerns over how the global and continental processes will work together, as well as questionsover authorizing Africa CDC to declare public health emergencies of continental securityled several African Member States to approach WHO for advice. Due to these requests, WHO understood there was a need to share advice more broadly and our African country representatives briefed their government counterparts.

One WHO official in a country office developed a brief to help inform his health authorities. Contrary to media reports, this was not an official document and was not widely circulated.

WHO believes a careful reflection on the interfacing between the declaration of a public health emergency of continental security and the global process would be ofbenefit.

As a long-standing partner and proponent of the Africa CDC,WHO fully applauds its elevation into a more robust and responsive institution as defined by Member States.

WHO commends the Africa CDCs work to date and supports further strengthening this essential institution, which as it becomes more fully resourced and empowered will take on a critical role in ensuring better health for all people across the Africancontinent.

WHO has been pleased to support the Africa CDC since the beginning, helping with its establishment by seconding a senior official who servedas the most senior advisor to the Director during the organizations first two years and by providing funding and technical collaboration.

A Memorandum of Understanding governs ourpartnershipand our staff work in tight collaboration on key health issues such as the COVID-19 pandemic and strengthening public health capacities of countries. This collaboration is critical to ensuring our Member States get consistent advice and complementary support from both organizations.

We look forward to a continued fruitful collaboration which will lead to the Africa we all want, where everyone is protected from diseases and has access to quality and affordable healthcare.

Read the original here:
WHO supports the leadership role of a strong Africa Centre for Disease Control and Prevention - WHO | Regional Office for Africa