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Significant Upcoding Risks Emerge with Medicare Advantage

YouCompli

Approximately 65 million Americans are enrolled in Medicare – about 34 million in traditional Medicare and the rest in Medicare Advantage. Traditional Medicare is administered by the federal government, and individuals pay a separate monthly premium for hospital visits, doctors/outpatient, and prescription drugs.

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Concerted Effort to Define Responsible Use of AI in Healthcare is Sorely Needed

Healthcare IT Today

The following is a guest article by Amy Hester, PhD, RN, BC, FAAN, Chairwoman and CEO at HD Nursing The growing use of artificial intelligence (AI) across a number of industries, particularly in healthcare, has shown both great promise as well as cause for alarm. Government’s AI Executive Order: A Step Forward or Falling Short?

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Upcoming Healthcare Regulations and Their Impact on Healthcare IT

Healthcare IT Today

Stephen Sofoul, SVP, Data & Decision Science Services at MultiPlan A critical challenge lies in the shortage of experienced financial analysts or data analysts capable of effectively analyzing the wealth of information that the healthcare industry holds. However, with healthcare being ever-evolving our regulations are also ever evolving.

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Frost & Sullivan's Top 10 predictions for healthcare in 2021

Healthcare IT News - Telehealth

Financial/Revenue Cycle Management Population Health Precision Medicine Telehealth Workforce From vaccines to virtual care, enterprise imaging to precision medicine, these are the growth areas that will shape the direction of healthcare, this year and beyond.

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Improving Patient Care With a “Prevent, Detect, Report” Strategy  

YouCompli

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. In addition, CMS education and outreach focuses on preventing, detecting, and reporting Medicare fraud and abuse.

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HITECH Compliance

AIHC

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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Sanctions and penalties for hiring excluded individuals in healthcare 

YouCompli

Do your hiring managers and Human Resources colleagues know what to look for? Department of Health and Human Services Office of Inspector General (OIG) has the authority to exclude individuals and entities from federally funded healthcare programs. Provision of unnecessary or substandard services.

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