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What Is Medical Billing Compliance?

Compliancy Group

One of the most common ways for providers and healthcare organizations to run afoul is to incorrectly or illegally bill and code for services or supplies. No matter the intent, noncompliance in medical billing can have severe consequences. It pays to know the law and avoid temptations to cut corners.

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Lawsuit Alleges Obamacare Plan-Switching Scheme Targeted Low-Income Consumers

Kaiser Health News

In turn, sales agents used the information to either enroll them in ACA plans or switch their existing policies without their consent. Such private sector platforms, which must be approved by the Centers for Medicare & Medicaid Services, streamline enrollment by integrating with the federal ACA marketplace, called healthcare.gov.

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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

Fraud in healthcare has run rampant in recent years, as evident by two incidents in which healthcare organizations billed insurance companies for things patients never received. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received. Attorney Philip R.

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A Health Consumer Bill of Rights: Assuring Affordability, Access, Autonomy, and Equity

Jane Sarashon

NABIP, whose members represent professionals in the health insurance benefits industry, drafted and adopted a new American Healthcare Consumer Bill of Rights launched at the meeting. Health Populi’s Hot Points: Is there an American Civil Right for health care?

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Orthopedic Billing Compliance Checklist – A Guide for Healthcare Providers

Medisys Compliance

Compliance with Regulatory Guidelines Ensure that all claims are submitted per all applicable laws and regulations, including the Health Insurance Portability and Accountability Act (HIPAA), the Affordable Care Act (ACA), and the Medicare Fraud, Waste, and Abuse (FWA) laws.

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Value-Based Health Care Needs All Stakeholders at the Table – Especially the Patient

Health Populi

health care, patient assistance programs, Medicare Advantage plans, and the bundling of proven high-value preventive services into the Affordable Care Act. These services are enumerated in Section 2713 in the ACA , prompting Dr. Kavita Patel to assert in the first panel of the day that, “2713 is my favorite number.”

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Key Factors in Choosing Oncology Billing Company

Medisys Compliance

It is crucial to verify that the billing company is adhering to industry standards, such as HIPAA (Health Insurance Portability and Accountability Act) regulations, which protect patients’ medical information.