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How To Prepare for an OIG Inspection

MedTrainer

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. That mean, maintaining compliance standards, efficient reporting, and conducting thorough internal audits are vital.

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Marketing, Telemarketing, Compliance & Healthcare

AIHC

Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM Due to the high volume of fraud schemes involving telemarketing revealed by the Department of Justice (DOJ) over recent years, it is important that providers heed “buyer beware” when engaging with a telemarketing firm. “If If it is too good to be true it probably isn't.”

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Understanding Sanction Screening: Safeguarding Healthcare Integrity Under HIPAA

Total Medical ComplianceHIPAA

In the intricate landscape of healthcare, compliance with regulations isn’t just a choice but a necessity. Regulatory Compliance: HIPAA mandates the protection of patient information and the prevention of fraudulent practices. HIPAA stands as a beacon of privacy and security standards within the industry.

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Are Provider Enrollment and Credentialing the Same?

MedTrainer

Provider enrollment is when a healthcare provider is registered with insurance networks or government payers , like Medicaid or Medicare. Provider enrollment confirms the healthcare provider meets and maintains certain compliance standards for the insurance or payer network. What is Provider Enrollment? What is Provider Credentialing?

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Quick Guide to the National Practitioner Data Bank (NPDB)

Provider Trust

In this quick guide, we’ll explore the importance of including NPDB monitoring in your routine license and exclusion monitoring to protect your organization and the patients you serve from fraud, waste, and abuse. Its mission is to enhance healthcare quality, defend the public, and decrease healthcare fraud and misuse in the U.S.

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Introduction to Telebehavioral Health

AIHC

Compliance Considerations for Best Outcomes Written in collaboration with the AIHC Volunteer Education Committee Delivering mental health services via telehealth has increased since the COVID-19 pandemic. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs.

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Privileges and Credentialing Aren’t the Same

MedTrainer

Additionally, the credentialing specialist may request a record of any pending and past medical malpractice cases and disciplinary actions from the appropriate authority. Meets compliance standards: Both processes verify a provider has met compliance standards. Look for these 10 attributes in a credentialing specialist.