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Compliance Risks Associated with Outlier Payments 

YouCompli

Raising prices on your hospital’s chargemaster can also raise your level of compliance grief. Price increases can sometimes result in inappropriate outlier payments. Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. If they were not, the hospital must return the funds.

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The Impact of MACRA on Cardiology Billing

Medisys Compliance

This article aims to simplify the impact of MACRA on your cardiology billing, empowering you to navigate these changes with confidence. MACRA replaced the previously used Sustainable Growth Rate (SGR) formula for Medicare physician payments. We offer a comprehensive suite of services designed to streamline MACRA compliance.

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Brief about Wound Care Reimbursements in Various Healthcare Settings

Medisys Compliance

In this article, we shared wound care reimbursements in certain healthcare facilities. Wound Care Reimbursements in Various Healthcare Settings Inpatient Hospital Wound care in an inpatient hospital setting is reimbursed through the Diagnosis-Related Group (DRG) payment system.

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Bonus Features – November 12, 2023 – 93% of clinicians use RPM in cardiac care rehab, telehealth flexibilities remain in place until the end of 2024, plus 25 more stories

Healthcare IT Today

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Health Payment Systems selected Madaket Health to manage its provider directory and roster requirements for No Surprises Act compliance.

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Zealous for Wellness: Deciding What Kind of Change You Want

Healthcare IT Today

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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CMS Imposes New Requirements on Payers to Improve Prior Authorization Process and Payer, Patient and Provider Communications

Hall Render

The Final Rule also imposes additional reporting requirements under the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals and for eligible clinicians reporting under the Promoting Interoperability performance category of the Merit-Based Incentive Payment System.

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Why Data Analytics are Critical in a Value-Based Care (VBC) Environment

AIHC

We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. In 1983 Medicare shifted to the inpatient Prospective Payment System (PPS) and DRGs (Diagnostic Related Groups) and only paying a limited number of days to the hospital regardless of the actual length of stay.