MedTrainer

APRIL 22, 2024

Several federal agencies highly recommend having a healthcare compliance committee — the key is to make the committee helpful, not just a regulatory checkbox. Compliance committees vary based on the size of the organization, the care setting, and the committee’s charter. What is a Healthcare Compliance Committee?

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Medisys Compliance

JANUARY 31, 2024

Introduction Understanding the details of Medicare coding and claims submission can be daunting for anyone. This article serves as a guide to help you avoid billing mistakes for Medicare and ensure smooth claims processing for your Medicare patients. Common Billing Mistakes 1.

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MedTrainer

NOVEMBER 27, 2023

Managing healthcare compliance in Ohio presents a unique set of challenges for compliance officers, healthcare professionals, and administrators. Organizations need to successfully navigate the regulatory landscape in order to provide efficient and ethical healthcare services, and to avoid consequences for non-compliance.

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Compliance Licensing Medicaid Medicaid 52

MedTrainer

DECEMBER 7, 2023

All healthcare organizations, along with their providers and compliance officers, must understand the requirements of each regulatory state agency that provides oversight. Robust, flexible, and reliable compliance programs must be developed to maintain compliance in Hawaii.

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Compliance Compliance Officers Licensing Medicaid 52

AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

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Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 52

Compliancy Group

DECEMBER 8, 2023

Compliance is a critical aspect of the healthcare industry. However, there are several high-risk areas where compliance issues can arise, potentially leading to legal troubles and compromised patient safety. Billing and Coding Practices Billing and coding errors are another area where compliance issues can arise.

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Compliance Medicare Medicare Fraud 52

Bill of Health

MAY 22, 2023

The selections feature topics ranging from an analysis of government and industry investments for recently approved drugs, to a discussion of court decisions on mifepristone, and an examination of the added therapeutic benefit associated with the top-selling brand-name drugs in Medicare. Galkina Cleary E, Jackson MJ, Zhou EW, Ledley FD.

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Pharmaceutical Industry Medicare Medicare Medicaid 157

AIHC

AUGUST 30, 2023

This article is educational only, and does not provide consulting or legal advice. What compliance issues need to be considered when drafting a marketing strategy? Let’s take a closer look at potential compliance risks. For example, if you’re an Internist, what better way to promote articles on diabetes.

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MedTrainer

DECEMBER 7, 2023

To sail smoothly through the complex rules and requirements, you need a deep knowledge of the most essential aspects of healthcare compliance in Maine. A successful compliance program involves adaptability, comprehensive planning, and insight into key compliance factors, including credentialing requirements.

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MedTrainer

DECEMBER 7, 2023

Healthcare compliance in New Mexico mirrors the state’s diverse culture, with unique regulations that differ from other states, such as credentialing documentation requirements for managed care organizations. New Mexico’s parity law requires insurers to cover telemedicine services to the same extent as in-person services.

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MRO Compliance

JULY 12, 2023

Accurate, properly documented, interoperable patient data is required to achieve CMS’s goal for 100 percent of Medicare (and the majority of Medicaid) beneficiaries to be enrolled in some type of accountable, or value-based, care arrangement by 2030. View Full Article

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Medicaid Medicaid Medicare Medicare 130

Health Law RX

FEBRUARY 21, 2024

The Centers for Medicare & Medicaid Services (CMS) has revised certain payment policies under the Medicare physician fee schedule, and updated provider and supplier enrollment regulations. Summary of Major Updates The below outlined changes are described in more detail in this article.

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MedTrainer

SEPTEMBER 8, 2023

Maintaining compliance with healthcare regulations and standards isn’t just a legal requirement; it’s a crucial element in upholding patient safety, data security, and the overall integrity of healthcare practices. Hear more on compliance essentials from a panel of expert healthcare surveyors. Why Is Healthcare Compliance Important?

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Compliance HIPAA Medicaid Medicaid 52

Compliancy Group

FEBRUARY 7, 2024

This is because the Centers for Medicare & Medicaid Services (CMS) have ramped up their efforts to identify organizations that have improperly billed for medical services. For healthcare organizations, understanding UPIC audits and preparing for them is essential to compliance. What is the Purpose of UPIC Audits?

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Electronic Health Reporter

APRIL 8, 2020

This article is copyrighted strictly for Electronic Health Reporter. There are several regulatory compliance requirements that healthcare organizations must follow. The article Regulatory Compliance For Healthcare Organizations appeared first on electronichealthreporter.com. Illegal copying is prohibited.

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Regulatory Compliance Compliance HIPAA Health Insurance 132

Medisys Compliance

APRIL 19, 2023

The Medicaid program in Florida provides medical services and assistance to low-income individuals and families. To participate in the Medicaid program, healthcare providers must meet several general requirements set forth by the Agency for Health Care Administration (AHCA).

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Medisys Compliance

MARCH 31, 2023

Ohio Medicaid is a government-sponsored healthcare program that provides medical benefits to eligible individuals in Ohio. To become a provider for Ohio Medicaid, you must first enroll in the Ohio Medicaid program. Here are the steps of provider enrollment for Ohio Medicaid: Provider Enrollment for Ohio Medicaid 1.

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MedTrainer

NOVEMBER 20, 2023

Managing healthcare compliance in Texas is nuanced and challenging. For successful compliance management in Texas, healthcare organizations need to develop a strong system for tracking and interpreting regulatory changes, and promptly adapt to these modifications.

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Hall Render

DECEMBER 12, 2023

On November 16, 2023, the Centers for Medicare & Medicaid Services (“CMS”) published proposed changes to the Medicare provider enrollment requirements in the Calendar Year 2024 Physician Fee Schedule final rule (“Final Rule”).

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Medicare Medicare Licensing Malpractice 40

Medisys Compliance

JUNE 16, 2023

G0108 is a Medicare code used for the initial preventive physical examination, also known as the IPPE or “Welcome to Medicare” visit. In this article, we will explore the guidelines surrounding how often G0108 can be billed.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 52

Medisys Compliance

APRIL 25, 2024

Introduction The ever-evolving world of healthcare billing can feel complex, and with the introduction of MACRA (Medicare Access and CHIP Reauthorization Act) in 2015, cardiology practices have faced some adjustments. MACRA replaced the previously used Sustainable Growth Rate (SGR) formula for Medicare physician payments.

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Medical Billing Outsourcing Medical Billing Medicare Medicare 64

MedTrainer

MAY 4, 2023

That includes many compliance professionals. There are plenty of compliance implications for the end of the Public Health Emergency on May 11, 2023 , and an assessment is a great place to start. This article will focus on the federal changes, but make sure to check with all states where your providers are licensed to stay up-to-date.

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Public Health Compliance COVID-19 COVID-19 Vaccine 52

Healthcare IT Today

JANUARY 2, 2024

The following is a guest article by Marlena Herrera, Director at Protegrity Healthcare organizations are becoming more lucrative targets for hackers, as their data is rich with extremely sensitive information and is often susceptible to vulnerabilities. Healthcare’s most valuable data is their patient or policyholder data.

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Compliance US Department of Health and Human Services HIPAA Health Insurance 69

YouCompli

FEBRUARY 22, 2023

Raising prices on your hospital’s chargemaster can also raise your level of compliance grief. Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. The CCR is determined by a hospital’s cost report that is reconciled with the local Medicare contractor.

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Compliance US Department of Health and Human Services Overpayments Overpayment 52

AIHC

FEBRUARY 7, 2024

This article provides a basic overview of Artificial Intelligence, Telehealth, Asynchronous Services and HIPAA privacy concerns. Please utilize resources provided within this article for more information. Medicaid policies on this issue vary from state to state. This information is not intended as legal or consulting advice.

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HIPAA Medicaid Medicaid Telemedicine 59

Medisys Compliance

FEBRUARY 20, 2023

Healthcare providers often get confused about the appropriate use of modifiers GA, GX, GY, and GZ while billing Medicare. GA modifier indicates that an Advance Beneficiary Notice (ABN) is on file and allows the provider to bill the patient if not covered by Medicare. Medicare does not pay for all health care costs.

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Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Medisys Compliance

JULY 13, 2023

Medicare recognizes the importance of diabetes self-management training and offers coverage for eligible beneficiaries. However, there are specific guidelines and conditions that need to be met for Medicare billing. Diabetes Education Billing Guidelines for Medicare Who May Furnish the Training?

Medicare 52

Medicare Medicare Medical Billing Outsourcing Health Outcomes 52

Medisys Compliance

MAY 19, 2022

The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. During the COVID-19 public health emergency, any health care provider who is eligible to bill Medicare can bill for telehealth services regardless of where the patient or provider is located. Eligible services.

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COVID-19 Medicare Medicare Medical Billing 52

AIHC

FEBRUARY 7, 2024

This article provides a basic overview of Artificial Intelligence, Telehealth, Asynchronous Services and HIPAA privacy concerns. Please utilize resources provided within this article for more information. Medicaid policies on this issue vary from state to state. This information is not intended as legal or consulting advice.

HIPAA 52

HIPAA Medicaid Medicaid Telemedicine 52

MedTrainer

MAY 16, 2024

In this article, we’ll explore the requirements for ASC training and what regulatory and accreditation course topics are required and recommended by role. ASC Compliance Training Requirements There isn’t a universal list of training requirements for all ASC employees. However, meeting ASC requirements is not as easy as it sounds!

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Medisys Compliance

MARCH 5, 2024

This article explores into the details of cardiology billing, offering insights into payer audits and reimbursement challenges in cardiology billing. This complexity is reflected in the coding and billing requirements set forth by government payers such as Medicare, as well as private insurance companies.

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Medical Billing Outsourcing Medical Billing Compliance Governance 105

Healthcare Law Blog

MAY 5, 2022

Department of Health and Human Services Office of Inspector (“OIG”) released a report that studied prior authorization denials and payment denials by Medicare Advantage Organizations (“MAOs”) (the “Report”). Thirteen percent of denied prior authorization requests met Medicare coverage rules. The OIG Report. additional test results).

Medicare 52

Medicare Medicare Licensing Health Insurance 52

Medisys Compliance

JULY 27, 2023

The complex landscape of billing regulations, ever-evolving guidelines, and the need for compliance can be overwhelming. In this article, we provide detailed answers to common questions asked by healthcare professionals regarding medical billing in Kentucky. This helps maintain compliance and reduce errors.

Medical Billing 52

Medical Billing Medicaid Medicaid Telemedicine 52

YouCompli

SEPTEMBER 13, 2023

Mitigating fraud, waste, and abuse (FWA) is taking on a new urgency for healthcare compliance professionals. Enforcement agencies are prioritizing efforts to deter FWA as more individuals enroll in government healthcare programs like Medicare and Medicaid, and telehealth services continue to evolve post-pandemic.

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US Department of Health and Human Services Compliance Officers Compliance Fraud 52

Medisys Compliance

APRIL 30, 2024

This article provides a comprehensive guide for anesthesiologists and providers on telehealth anesthesia billing, covering key aspects of telehealth billing. Eligible Services for Telehealth Billing The Centers for Medicare & Medicaid Services (CMS) maintains a list of services eligible for telehealth billing.

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Medical Billing Outsourcing Medicare Medicare Informed Consent 59

Hall Render

OCTOBER 31, 2022

The Centers for Medicare & Medicaid Services (“CMS”) has retooled guidance it armed surveyors with regarding how to survey skilled nursing facilities for compliance with the CMS staff vaccine requirements. Key Surveyor Guidance Revisions. Key Surveyor Guidance Revisions. Enforcement. Surveyor Review.

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Nurses Compliance COVID-19 COVID-19 Vaccine 40

Healthcare IT Today

NOVEMBER 15, 2023

The previous article in this series explained some of the ways payers, providers, and digital health companies demonstrate that they have made a positive difference in their patients’ lives. ” This article looks at the measurements and reporting strategies used by some specific companies. offering in-home treatment.

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