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How Medicare Advantage Programs Can Address Social Risk and Improve Health Outcomes

HIT Consultant

Brian Norris, Managing Director of Strategic Consulting at MedeAnalytics There are almost 33 million people enrolled in eligible Medicare programs. Nearly half are enrolled in Medicare Advantage (MA) plans, and that number is expected to continue its climb.

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Avoiding Costly Credentialing Issues in Healthcare

Verisys

However, the process itself can be complicated and time-consumingand when things go wrong, it can lead to financial setbacks, medical standard compliance issues, and unnecessary stress. Poor communication between departments : Credentialing requires input from many players, including HR, compliance teams, and insurance payers.

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Avoiding Billing Mistakes for Medicare

Medisys Compliance

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. Ensure they have current Medicare coverage and no pending eligibility changes.

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Healthcare Compliance Certification Is Within Your Reach

MedTrainer

Healthcare compliance is a critical part of any organization’s business model. The professionals who manage compliance are the front lines of preventing medical errors, deterring fraud, and staying in good standing with federal payers like the Centers for Medicare and Medicaid Services (CMS).

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Healthcare Providers’ Role in Preventing Fraud, Waste, and Abuse 

American Medical Compliance

The Department of Health and Human Services (HHS) estimated that improper payments in the Medicare and Medicaid programs exceeded $100 billion from 2016 to 2023. The post Healthcare Providers’ Role in Preventing Fraud, Waste, and Abuse appeared first on American Medical Compliance.

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What Are The Current Regulatory Changes And Compliance Requirements That ASCs Need To Be Aware Of In Their Billing Practices?

Healthcare IT Today

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. However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance. ASCs must also meet Medicare’s Conditions for Coverage.

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Show the benefits of investing in your healthcare regulatory compliance program

YouCompli

The same tool nurses use to communicate about health emergencies – can help you secure investment in your compliance department. . Healthcare compliance professionals who want to make a case for investing in a healthcare regulatory change management solution like YouCompli are using the SBAR framework: Concisely explain the situation.