Healthcare IT Today

JUNE 29, 2023

Each ASC is responsible for ensuring that they are in compliance with the numerous statutes and regulations that are in place at both the state and federal levels. Understanding ASCs Regulatory Changes and Their Billing Practices Outpatient surgery centers (ASCs) perform many surgical procedures outside of hospitals.

Compliance 52

Compliance Medicare Medicare Medical Billing 52

Healthcare It News

MAY 2, 2024

" She also said that she heard that the loan conditions were very suspect, such as a clause that the recipient could not use a UHG competitor, and some clinics and hospitals in her district decided not to take them. "Because we were trying to help quickly we undershot, and in this case, we massively undershot."

US Department of Health and Human Services 275

US Department of Health and Human Services HIPAA Ransomware Governance 275

Medisys Compliance

MARCH 14, 2023

Wound care is provided in various healthcare settings like inpatient hospital, outpatient clinics, long-term care facilities, home health settings, hospice and skilled nursing facilities. For example, patients who require ongoing wound care but do not need to be hospitalized can receive treatment in outpatient clinics.

Payment Systems 52

Payment Systems Medical Billing Medicare Medicare 52

Medisys Compliance

FEBRUARY 9, 2024

Hospital Outpatient Prospective Payment System (OPPS) Updates OPPS is a payment system used by Medicare to reimburse hospitals for outpatient services, including some wound care procedures. These updates reflect changes in healthcare costs and utilization patterns.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

Hall Render

FEBRUARY 24, 2022

Following this reporting, impacted providers and teaching hospitals will have the opportunity to review reported payments and investments and to dispute any incorrect reports until May 15, 2022. Until this reporting year, the term “Covered Recipients” has referred only to physicians (excluding medical residents) and teaching hospitals.

Hospitals 40

Hospitals Payment Systems Nurses Compliance 40

Healthcare IT Today

MAY 9, 2024

Healthcare providers, technology companies, and regulated lenders can collaborate to drive digital transformation and financing accessibility while meeting regulatory and compliance standards and protecting the patient’s financial well-being. Late or no payment from patients is a significant issue for U.S. Some 40% of U.S.

Patient Satisfaction 75

Patient Satisfaction Payment Systems Compliance Governance 75

Healthcare IT Today

NOVEMBER 15, 2023

Resilient Healthcare Employs Extensive Data Analytics Resilient Healthcare provides in-home care for conditions that have traditionally required a hospital stay. Jackleen Samuel, president and CEO, says that they analyze patient demographics, clinical information, and process indicators such as medication compliance and service utilization.

Medicare 94

Medicare Medicare Hospitals Compliance 94

Medisys Compliance

JUNE 16, 2022

What is 3-Day Payment Window? Medicare’s 3-day (or 1-day) payment window applies to outpatient services that hospitals and hospital wholly owned or wholly operated Part B entities furnish to Medicare beneficiaries. Hospital subject to 1-Day Payment Window. Inpatient rehabilitation hospitals and units.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Hospitals Medicare 52

Hall Render

MARCH 20, 2024

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.

Medicare 40

Medicare Medicare Health Insurance Medicaid 40

AIHC

NOVEMBER 29, 2023

Hospital reimbursement also changed. 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. It’s important for compliance and historical trend analysis.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

AIHC

NOVEMBER 29, 2023

Hospital reimbursement also changed. 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. It's important for compliance and historical trend analysis.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare IT Today

FEBRUARY 2, 2024

This quote lies at the heart of integrity, a powerful concept that applies equally critically in the healthcare payments environment as it does in daily life. In adopting pre-payment systems, the synergy between payers and providers is paramount.

Payment Systems 66

Payment Systems Overpayments Overpayment Medical Billing 66

Medisys Compliance

AUGUST 4, 2022

Proposed ESRD Payment System. This rule also proposes an update to the Acute Kidney Injury (AKI) dialysis payment rate for renal dialysis services furnished by ESRD facilities for calendar year (CY) 2023. Direct nursing services include registered nurses, licensed practical nurses, technicians, social workers, and dietitian.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Payment Systems Medicare 59

Verisys

JUNE 13, 2023

A big thanks to our compliance team, who monitors state, federal, and international updates. If online applications and payments were submitted during this time period, please do not resubmit without checking the status of the license or registration. June Regulatory Update – The best resource for monthly updates.

COVID-19 Vaccine 52

COVID-19 Vaccine US Department of Health and Human Services COVID-19 Licensing 52

HIT Consultant

AUGUST 28, 2023

.” The standard playbook for success in the medical facility industry focuses on factors like identifying and delivering in-demand services, establishing a strong brand and building relationships with local hospitals and physicians to create a referral network. But mergers and acquisitions can lead to major headaches for AP processes.

Payment Systems 103

Payment Systems Compliance Medicaid Medicaid 103

Medisys Compliance

APRIL 11, 2024

You can bill for services provided in various settings, including your private practice office, hospitals, outpatient clinics, and even some telehealth platforms. Telehealth Considerations Telehealth has become an increasingly important aspect of mental healthcare delivery.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

HIT Consultant

SEPTEMBER 7, 2021

With the No Surprises Act taking effect in less than four months, it is critical that hospitals and providers leverage technology to ensure patients are informed about their expected care costs prior to receiving services. Kwon, JD, MHA, R1 Manager, Advisory & Assurance – Regulatory.

Medical Billing 52

Medical Billing Hospitals Patient Satisfaction Medicaid 52

Healthcare IT News - Telehealth

AUGUST 19, 2020

Staff members were unsure if Medicare and Medicaid would honor the prospective payment-system rate. Decisions were not made yet on the level of payment. Currently, there is a 96% overall compliance rate. " Finally, prior to CMS loosening telemedicine policy for the pandemic, reimbursement was a concern.

COVID-19 171

COVID-19 Telemedicine Compliance HIPAA 171

Healthcare Law Blog

JANUARY 26, 2024

Merit-based Incentive Payment System (“MIPS”) eligible clinicians, operating under the Promoting Interoperability performance category of MIPS, and eligible hospitals and critical access hospitals (“CAHs”), operating under the Medicare Promoting Interoperability Program, are impacted by the Final Rule, as well.

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

C&M Health Law

DECEMBER 23, 2022

The regulations impact CMS-regulated payers and provide incentives for providers and hospitals that participate in the Medicare Promoting Interoperability Program and the Merit-based Incentive Payment System (MIPS). Patient Access API. (i)

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Hall Render

MAY 2, 2023

CMS expects all providers to be in compliance with the requirements for PASARR with all admissions taking place after May 11, 2023. Three-Day Prior Hospitalization/Qualifying Hospital Stay. This waiver provides temporary emergency coverage of SNF services without a qualifying hospital stay. Benefit Period Blanket Waiver.

Nursing Homes 40

Nursing Homes Public Health Nurses COVID-19 40

Healthcare IT Today

MAY 22, 2023

The current healthcare system is rife with administrative inefficiencies and redundancies, which can lead to delayed or denied payments for payers. Payers have to manage complex payment systems, track performance, and ensure regulatory compliance.

Regulatory Compliance 83

Regulatory Compliance Payment Systems Compliance Hospitals 83

Hall Render

NOVEMBER 28, 2023

On November 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update Final Rule (“2024 Final Rule”), which has since been filed in the Federal Register. Hospices need to be much more vigilant about compliance.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

Health Care Law Brief

NOVEMBER 17, 2021

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) released its final rules for the 2022 Medicare Physician Fee Schedule (PFS Final Rule) and 2022 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (OPPS Final Rule).

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

Health Blawg

JANUARY 16, 2019

As in the case of the RFI regarding Stark and AKS, this is prompted in large part by the move from volume to value, and the widespread belief that value-based payment systems will right the listing ship of the U.S. healthcare “system.” ” (Let’s just say here that the jury is still out.

HIPAA 60

HIPAA Fraud Governance Payment Systems 60

Health Blawg

JANUARY 16, 2019

As in the case of the RFI regarding Stark and AKS, this is prompted in large part by the move from volume to value, and the widespread belief that value-based payment systems will right the listing ship of the U.S. healthcare “system.” ” (Let’s just say here that the jury is still out.

HIPAA 60

HIPAA Fraud Governance Payment Systems 60

Drug & Device Law

JULY 31, 2023

Sharp Memorial Hospital , 264 Cal. Sharp Memorial Hospital, Inc. , 2011), construed this statute and held that an “electronic payment system does not come within the strictures of the statute” because it was not a “product” as contemplated in Restatement Third §19. 673, 676 (Cal. 673, 676 (Cal. See also Green v.

Governance 52

Governance Payment Systems Hospitals Licensing 52