Healthcare IT Today

APRIL 4, 2025

The Centers for Medicare & Medicaid Services (CMS) requires translation of key documents, including Annual Notices of Change (ANOCs), Evidence of Coverage (EOCs), and Summaries of Benefits (SBs), for any language group comprising more than 5% of a plans service area population. How Flexible is the Workflow?

Medicare 84

Medicare Medicare Medicaid Medicaid 84

Healthcare It News

SEPTEMBER 9, 2022

The Centers for Medicare and Medicaid Services is inviting patients and their families, providers, clinicians, consumer advocates, healthcare professional associations, individuals serving underserved communities and all CMS stakeholders serving populations facing disparities in health and healthcare to submit public comments by November 4.

COVID-19 284

COVID-19 Medicaid Medicaid Public Health 284

Medisys Compliance

DECEMBER 24, 2024

However, billing for teletherapy services can be complex, requiring a deep understanding of coding, documentation, and payer-specific policies. Some of the documentation tips for CPT codes include: Include the start and end time of the session. Document that the service was provided via telehealth, including the platform used (e.g.,

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicaid Medicaid Medical Billing 59

Electronic Health Reporter

MARCH 19, 2024

Selecting an inpatient drug rehab accepting Medicaid is vitally important to individuals looking for treatment, yet each facility offers different approaches and may impose different requirements upon individuals – some may need extra documentation or […] The article Choosing the Right Outpatient Drug Rehab That Accepts Medicaid appeared (..)

Medicaid 91

Medicaid Medicaid 91

Healthcare IT News - Telehealth

JULY 9, 2020

The Centers for Medicare and Medicaid Services has put together further detailed guidance for how healthcare providers should be documenting and reporting electronic clinical quality measures for telehealth encounters.

Payment Systems 216

Payment Systems Medicaid Medicaid Medicare 216

Healthcare It News

OCTOBER 31, 2022

Through the secure collection, documentation, reporting, access and use of data across provider types, ONC aims to address health inequities that have their root causes in poverty and racism. They're not limited to using the SDOH standards in ONC's guide in their work, according to the post. THE LARGER TREND.

Licensing 338

Licensing Medicaid Medicaid Health Outcomes 338

HealthIT Answers

APRIL 22, 2025

Nay helped her apply for Medicaid and food assistance and obtain copies of her birth certificate and other identification documents needed to apply for housing assistance. The post Talent Tuesday: Montana Examines Ways To Ease Health Care Workforce Shortages appeared first on Health IT Answers.

Medicaid 59

Medicaid Medicaid Medicare Medicare 59

Med-Net Compliance

JUNE 13, 2022

Three independent clinical laboratories, their owner and holding company, an additional independent clinical laboratory and its owner, two laboratory marketing companies, and a Massachusetts physician have been charged in connection with Medicaid fraud, money laundering, and kickbacks involving urine drug tests?that

Fraud 105

Fraud Medicaid Medicaid 105

HIT Consultant

DECEMBER 3, 2024

Many care settings are required to perform elaborate intake and documentation before even beginning treatment for a patient. The Centers for Medicare & Medicaid Services (CMS) added codes for Digital Mental Health Treatment in its 2025 Medicare Physician Fee Schedules. Automating intake and paperwork.

FDA 111

FDA Medicare Medicare Medicaid 111

Hall Render

JANUARY 29, 2025

The Centers for Medicare & Medicaid Services (CMS) is reinforcing its emphasis on hospice quality of care and identifying fraud. Hospice providers can protect their patients and safeguard their businesses against enforcement actions and fraud allegations by focusing on compliance, enhancing documentation and maintaining survey readiness.

Fraud 80

Fraud Medicare Medicare Compliance 80

Compliance Now

AUGUST 10, 2023

As background, according to federal Health Insurance Portability and Accountability Act (HIPAA) rules, individuals have 60 days from losing CHIP and Medicaid eligibility to elect coverage under their group plan. Of course, amending plan documents to reflect the changes is also necessary.

Medicaid 100

Medicaid Medicaid Compliance COVID-19 100

Compliance Now

AUGUST 10, 2023

As background, according to federal Health Insurance Portability and Accountability Act (HIPAA) rules, individuals have 60 days from losing CHIP and Medicaid eligibility to elect coverage under their group plan. Of course, amending plan documents to reflect the changes is also necessary.

Medicaid 100

Medicaid Medicaid Compliance COVID-19 100

Healthcare It News

DECEMBER 6, 2023

Unfortunately, Medicaid does not provide reimbursement for RPM services. "With more than half of our patients on Medicaid and another quarter uninsured, we had no way to fund the initial startup costs or the ongoing service costs," said Howard Rubin, CIO at Evara Health.

Nurses 311

Nurses Medicaid Medicaid Hospitals 311

MRO Compliance

JANUARY 16, 2025

To address these gaps, the Centers for Medicare & Medicaid Services (CMS) now mandates the use of FHIR-based APIs for data sharing. For payers, staying ahead of these changes means investing in systems that track documentation and manage disputes efficiently.

Overpayments 130

Overpayments Overpayment Regulatory Compliance Patient Satisfaction 130

AIHC

APRIL 22, 2025

For compliance professionalsparticularly those working in environments regulated by Medicare, Medicaid, HIPAA, and federal contractsit is essential to understand the scope and implications of whistleblower protections under current U.S. The technician files a complaint under both the FCA and state labor law.

Compliance 89

Compliance HIPAA Compliance Officers Fraud 89

Healthcare IT Today

JANUARY 19, 2025

Personal emergency response system LogicMark expanded access to devices through Medicaid waivers in six states. Luke’s Health System chose Ambience Healthcare for AI-powered documentation and saw a 40% decrease in documentation outside working hours. Veradigm added SDoH and mortality data to its ambulatory EHR database.

Medicaid 85

Medicaid Medicaid Telemedicine Hospitals 85

Verisys

FEBRUARY 3, 2025

A well-organized checklist can simplify this process and help avoid delays caused by missing or incomplete required documents. Understanding Medical Credentialing Healthcare credentialing ensures that both the professional credentials and the necessary documentation are verified.

Malpractice 52

Malpractice Regulatory Compliance Licensing Compliance 52

AIHC

MARCH 31, 2025

The "Sunshine Act," officially known as the Physician Payments Sunshine Act, mandates those manufacturers of drugs, medical devices, and biologics report payments and transfers of value to physicians and teaching hospitals to the Centers for Medicare & Medicaid Services (CMS).

Compliance 64

Compliance COVID-19 Compliance Officers Medicaid 64

Total Medical Compliance Resources

APRIL 16, 2025

The monitoring results must be documented and kept according to local and state regulations. Several regulatory agencies, including the Joint Commission and Centers for Medicare and Medicaid mandate documentation. The sterilizer gauges or displays are observed for each of these parameters and those results are documented.

Medicaid 52

Medicaid Medicaid Nurses Medicare 52

Healthcare It News

APRIL 29, 2024

The GeekWire report said that the startup is additionally working with hospital networks and Medicaid providers to reach patients who face challenges accessing traditional healthcare facilities and life insurance providers. The company's application walks users through tests and uploads results by Bluetooth.

Public Health 300

Public Health Governance Medicaid Medicaid 300

Medisys Compliance

FEBRUARY 24, 2025

Factors influencing reimbursement include the payer type ( Medicare , Medicaid, commercial insurance), geographic location, and specific contract agreements. Key elements to include in your documentation for group therapy billing purposes are: Date and time of session: Clearly document the date on which the group therapy session took place.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 59

MRO Compliance

JULY 12, 2023

Accurate, properly documented, interoperable patient data is required to achieve CMS’s goal for 100 percent of Medicare (and the majority of Medicaid) beneficiaries to be enrolled in some type of accountable, or value-based, care arrangement by 2030.

Medicaid 130

Medicaid Medicaid Medicare Medicare 130

Medisys Compliance

JANUARY 16, 2025

The Centers for Medicare & Medicaid Services (CMS) provides comprehensive behavioral health billing guidelines, which can be overwhelming due to their technical nature and breadth. Documentation should support the need for these services, linking them directly to the patients diagnosis and treatment plan.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Fraud 59

Medisys Compliance

MARCH 19, 2025

Accurate and thorough documentation is crucial for both CPT and ICD-10 coding. Inadequate or ambiguous documentation can lead to coding errors and subsequent claim denials. Accurate medical necessity documentation plays a crucial role in both obtaining prior authorizations and supporting claims.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

Medisys Compliance

APRIL 8, 2025

Unlike general medical billing, psychiatric billing involves unique coding practices, session-based reimbursements, and strict documentation requirements. Compliance and Documentation Management: Adhering to HIPAA and payer-specific billing policies. Maintaining detailed clinical documentation to support claims and audits.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Compliance HIPAA 59

Healthcare IT News - Telehealth

MARCH 24, 2021

They also say they'd love to see peripheral device integrations, translation services during visits, documentation and platform availability in multiple languages. Department of Health and Human Services to issue guidance to states about how to increase access to telehealth under Medicaid and the Children’s Health Insurance Program.

Telemedicine 203

Telemedicine Health Insurance Medicaid Medicaid 203

AIHC

NOVEMBER 12, 2024

Teaching hospitals need to establish guidelines addressing this matter, while medical schools should revise their curriculum to encourage a culture where healthcare providers and trainees consistently obtain and appropriately document informed consent from patients before conducting any sensitive examinations.

Informed Consent 98

Informed Consent HIPAA Compliance Hospitals 98

Healthcare IT News - Telehealth

OCTOBER 27, 2020

The Centers for Medicare and Medicaid Services announced earlier this month , for example, that it would add 11 virtual services to its reimbursement list during the COVID-19 public health emergency – following in the footsteps of its earlier flexibilities for virtual care.

COVID-19 202

COVID-19 Governance Medicare Medicare 202

Hall Render

MARCH 27, 2025

The Centers for Medicare & Medicaid Services (CMS) has given surveyors additional rules and updates to allow surveyors to assess and cite violations of the regulations on nursing homes with admission agreements that create prohibited third-party guarantee of resident payments.

Nursing Homes 52

Nursing Homes Nurses Medicaid Medicaid 52

Medisys Compliance

APRIL 29, 2025

ICD-10-CM (International Classification of Diseases) Codes: Used to document patient diagnoses and clinical conditions. Documenting the complete sequence of diagnostic and therapeutic steps is vital. Documentation Gaps: Incomplete or unclear provider documentation can lead to claim denials or revenue loss.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicare 59

Healthcare IT News - Telehealth

AUGUST 21, 2020

Most of its patients fall below the poverty line, and most qualify for Medicaid. Administrators worked with the vendor to pull together supporting documentation and schedule training sessions for providers. All the documentation in the telehealth app went directly into the EHR, saving time. THE PROBLEM.

COVID-19 213

COVID-19 Telemedicine Medicaid Medicaid 213

Healthcare It News

JANUARY 4, 2022

"The adoption of hospital-at-home programs across the country has been rapid, with nearly 200 hospitals participating in the Centers for Medicare and Medicaid Services’ Acute Hospital Care at Home program in only a year since its launch," said Majmudar.

COVID-19 362

COVID-19 Hospitals Nurses Medicaid 362

American Medical Compliance

OCTOBER 25, 2024

The healthcare industry is highly regulated, with various laws such as the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH), and the Medicare and Medicaid Services (CMS) regulations shaping operations.

Compliance 105

Compliance Fraud Compliance Framework HIPAA 105

AIHC

APRIL 18, 2022

Undertaking and documenting reasonable collection efforts will satisfy the second requirement, and the completion of those efforts will satisfy the fourth. As with many areas of healthcare, the saying “if it was not documented, it did not happen” certainly applies. The debt was actually uncollectible when claimed as worthless.

Medicare 98

Medicare Medicare Medicaid Medicaid 98

Healthcare Blog

JANUARY 19, 2025

However, the success of swing bed programs hinges on strict adherence to Medicare Swing Bed Rules , a set of regulations established by the Centers for Medicare & Medicaid Services (CMS) to ensure compliance and optimize patient care. Provide a framework for proper documentation and billing practices.

Medicare 52

Medicare Medicare Compliance Nurses 52

Healthcare IT News - Telehealth

SEPTEMBER 20, 2021

"We have seen all too often criminals who engage in health care fraud – stealing from taxpayers while jeopardizing the health of Medicare and Medicaid beneficiaries," said Deputy Inspector General for Investigations Gary L. More than $1.1 billion of that loss involved allegedly fraudulent claims related to telemedicine.

Fraud 206

Fraud Telemedicine Medicare Medicare 206

Medisys Compliance

MARCH 24, 2025

Whether youre billing through private insurers, Medicare, Medicaid, or other payers, following urgent care billing guidelines is essential to minimize denials and optimize revenue. For example, if billing for prolonged services, ensure time spent is clearly documented. How to improve urgent care billing accuracy?

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicaid 59