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Navigating the Intersection of Payment Integrity and Provider Relations in Healthcare

Innovaare Compliance

The Importance of Payment Integrity Payment integrity is crucial for health plans to control costs, reduce fraud, waste, and abuse (FWA), and ensure the accuracy of healthcare payments. The Centers for Medicare & Medicaid Services (CMS) reported that in the fiscal year 2020, they recovered $3.1

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These are the compliance issues providers should be preparing for, post-PHE

Healthcare IT News - Telehealth

While it is important to carefully consider the most effective methods of providing care and the intended purpose behind various reimbursement, privacy, and fraud and abuse regulations, it is also clear that healthcare delivery has always and continues to evolve, and the regulatory framework needs to do the same. PTs, OTs, and SLPs).

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Introduction to Telebehavioral Health

AIHC

Increasing importance on patient satisfaction, providing efficient and quality care, and minimizing costs have also led to higher telehealth implementation. Medicare covers many telebehavioral and telemental health services including audio-only services. This includes understanding various fraud and abuse laws.

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Health Provider News – October 7, 2022

Hall Render

Judge orders Anthem to face lawsuit over alleged Medicare overpayments. Delaware retirees protest switch to Medicare Advantage plan. Bayfront Health takes in ICU patients evacuated from Lee Memorial, recovering from Hurricane Ian. Local Jax health care provider settles fraud allegations by paying $700,000.

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Health Provider News

Hall Render

To qualify, facilities must close their beds Amazon’s physician acquisition strategy As Many Hospitals Continue to Face Significant Financial Challenges, MedPAC Recommends Highest Ever Medicare Payment Update Change competitors step in but breaking up may be hard to do CMS to launch new primary care ACO program Congress unveils $1.2T

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KHN’s ‘What the Health?’: Finally Fixing the ‘Family Glitch’

Kaiser Health News

Meanwhile, open enrollment for Medicare begins Oct. 15, when beneficiaries can join or change private Medicare Advantage plans or stand-alone prescription drug plans. Many seniors are happy with their Medicare Advantage plans, which often offer more benefits than traditional Medicare at a reduced cost.