Remove ACA Remove Compliance Officers Remove Fraud Remove Medicaid
article thumbnail

What is a Certified Fraud Examiner (CFE)?

MedTrainer

In healthcare especially, fraud is something responsible providers need to be on the lookout for. It’s why many organizations choose to work with a Certified Fraud Examiner as part of their ongoing efforts to remain responsible and compliant with financial best practices. What is a Certified Fraud Examiner?

Fraud 52
article thumbnail

The History of Healthcare Compliance

MedTrainer

Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. Compliance in healthcare began to encompass billing, fraud, and abuse prevention. Compliance efforts expanded to encompass EHR security.

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Which Compliance Framework Governs the Healthcare Industry?

MedTrainer

It conducts audits, investigations, and evaluations to ensure efficiency and integrity in HHS programs, including Medicare and Medicaid. The OIG also enforces standards for healthcare providers and suppliers to prevent fraud and imposes penalties for non-compliance. Designate a compliance officer and/or compliance committee.

article thumbnail

What Is Medical Auditing?

MedTrainer

They review healthcare claims and billing practices to ensure accuracy, detect fraud or abuse, and assess compliance with the payer’s policies and guidelines. Federal Government Audits These audits are performed by government agencies such as the Centers for Medicare and Medicaid Services (CMS).

article thumbnail

Health Provider News

Hall Render

s Socially Determined aims to address potential gaps in Medicaid enrollment Lawsuits Mount Against DC Health Link Over Breach of Congress Members’ Data DC COVID-19 centers closing Friday Mayor Bowser Canceling $90 Million in Medical Debt for up to 90,000 DC Residents DELAWARE ChristianaCare CEO Dr.