Physician Credentialing Company

DECEMBER 27, 2024

It gets used by healthcare providers, medical coders, insurance companies, the government and even patients. Medicare reimbursement rates vary slightly by geographic location and annual fee schedule updates made by the Centers for Medicare & Medicaid Services (CMS). Malpractice RVU: The cost of your liability insurance.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Provider Trust

JULY 8, 2022

Department of Health and Human Services (HHS) and contains medical malpractice payments and adverse action reports on healthcare professionals. Below are the significant laws and regulations that govern NPDB operations: NPDB Regulations. For more information, view the webinar on demand. Healthcare Legislation & Regulations.

Licensing 52

Licensing Malpractice Fraud Medicaid 52

Verisys

AUGUST 31, 2023

Here are seven red flags to look out for and the reasons why: Incomplete or inconsistent application: Missing or conflicting data regarding education, training, work history, licensure, or malpractice history might indicate false information or attempts to conceal relevant details.

Malpractice 52

Malpractice Fraud Medicaid Medicaid 52

Verisys

DECEMBER 5, 2023

An Office of Inspector General (OIG) search of the List of Excluded Individuals/Entities (LEIE) indicates if the licensee is excluded from participating in government-funded programs. The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs.

Governance 52

Governance Licensing Malpractice Medicaid 52

Verisys

MARCH 1, 2022

An Office of Inspector General (OIG) search of the List of Excluded Individuals/Entities (LEIE) indicates if the licensee is excluded from participating in government-funded programs. The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs.

Governance 52

Governance Licensing Malpractice Medicaid 52

Medisys Compliance

MARCH 27, 2023

These terminologies are briefly discussed below for better understanding: Provider enrollment: This refers to the process of enrolling a healthcare provider with an insurance plan or government program, such as Medicare or Medicaid. By meeting these requirements, providers can expand their patient base and increase revenue.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Malpractice Governance Patient Satisfaction 52

Verisys

AUGUST 17, 2023

Mitigating liability and legal risks Malpractice claims and legal disputes can financially and emotionally drain healthcare providers and organizations. Medical staff service teams typically check at least half a dozen primary sources to properly verify a healthcare provider’s credentials.

Malpractice 52

Malpractice Licensing Compliance Medicaid 52

MedTrainer

FEBRUARY 5, 2024

Provider enrollment is when a healthcare provider is registered with insurance networks or government payers , like Medicaid or Medicare. The employer may also review any pending and past medical malpractice cases or disciplinary actions. We’ll also review why both processes are vital for healthcare organizations.

Licensing 52

Licensing Governance Compliance Fraud 52

AIHC

SEPTEMBER 5, 2023

Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs. This is also called “store-and-forward telemedicine.”

COVID-19 59

COVID-19 Telemedicine Informed Consent Compliance 59

MedTrainer

NOVEMBER 27, 2023

Ohio Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The Ohio Department of Health (ODH) is key to safeguarding and enhancing the health of Ohio residents. For over a century, OHA has been dedicated to assisting member hospitals in addressing community health needs.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Verisys

DECEMBER 23, 2021

Provider enrollment is the application process by which a practitioner is approved to seek reimbursement from government and/or third-party payers or seek admitting privileges at a hospital. It includes: The provider enrollment process for various government health plans. High number of malpractice cases. Vague references.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

MedTrainer

AUGUST 5, 2024

Proper privileging documentation is also critical to meet the standards of regulatory bodies such as the Centers for Medicare and Medicaid Services ( CMS ) and the National Committee for Quality Assurance ( NCQA ). Such lawsuits can threaten a hospital’s ability to participate in federally funded programs like Medicare and Medicaid.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

AUGUST 2, 2023

It involves collecting and reviewing information such as education, training, licensure, certifications, work history, malpractice history, and references — all in pursuit of verifying that providers are who they say they are and qualified to deliver legitimate, safe, and ethical care.

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

MedTrainer

MARCH 14, 2024

Additionally, the credentialing specialist may request a record of any pending and past medical malpractice cases and disciplinary actions from the appropriate authority. Whether it’s government regulation or healthcare facility requirements is a matter. Upon completion and approval, the provider can begin billing for medical services.

Malpractice 52

Malpractice Licensing Hospitals Compliance 52

MedTrainer

DECEMBER 2, 2024

Diversification of Payer Sources FQHCs are not limited to government funding through Medicaid and Medicare. Familiarize yourself with any payer-specific requirements such as proof of malpractice insurance, state-approved alternatives, and specific forms like the special needs survey or disclosure of ownership statement.

Licensing 52

Licensing Malpractice Compliance Medicaid 52

MedTrainer

MAY 6, 2024

Department of Commerce National Technical Information Service (when applicable) Disciplinary history or adverse actions related to licensure and DEA registration, which we query through state licensing boards and the National Practitioner Databank (NPDB) Malpractice insurance claim history to examine any possible trends and to look for evidence that (..)

Licensing 52

Licensing Malpractice Health Insurance Medicaid 52

Physician Credentialing Company

OCTOBER 25, 2024

Medicare and Medicaid may have different payment systems from those of the private health insurance plans. The lack of documentation may result in an audit, leading to claim denial and fines for noncompliance with Medicare and Medicaid regulations.

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

AIHC

APRIL 25, 2022

As AIHC advises, another resource is legal advice through your malpractice insurance company. Medicaid programs often restrict the type of providers that can be reimbursed when delivering services via telehealth. During the COVID-19 public health emergency (PHE), many states waived this requirement or provided specific exceptions.

HIPAA 52

HIPAA COVID-19 Compliance Compliance Officers 52

Verisys

MARCH 30, 2023

Healthcare organizations must regularly check practitioners’ qualifications and license status to comply with regulations and to ensure payment from private and government agencies like Medicare and Medicaid. What are the requirements for medical credentialing?

Licensing 52

Licensing Malpractice Medicaid Medicaid 52

Health Law Advisor

NOVEMBER 2, 2022

In the 2023 Outpatient Prospective Payment System Final Rule (OPPS Final Rule), released in pre-publication form on November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) adopts final regulations governing REHs. This monthly facility payment will increase after CY 2023 at the hospital market basket percentage increase.

Medicare 52

Medicare Medicare Hospitals Malpractice 52

Med Law Blog

MAY 1, 2023

Please note that the potential for ulterior financial motives does not automatically presume that the intent is somehow suspect, in the same way that potential medical malpractice concerns does not legitimately question the clinical motives of all other providers.

Nursing Homes 52

Nursing Homes Malpractice Hospitals Nurses 52

NY Health Law

APRIL 15, 2021

While the laws governing telehealth were becoming gradually more permissive, progress was slow. Pending legislation addresses the amount of reimbursement available for telehealth (both by Medicaid and commercial insurers) and permissible modalities (including asynchronous telemedicine).

Informed Consent 52

Informed Consent Malpractice Telemedicine Medicaid 52

Hall Render

MAY 13, 2022

Judge awards $5 million to NH woman in medical malpractice case. Troubled NC nursing home set to lose nearly all its government funding — and patients. Government watchdog: Health care giants improperly denied Medicare benefits. Hospital association sues DHS over pro-union language in Medicaid contracts. NEW HAMPSHIRE.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

DECEMBER 20, 2024

United Therapeutics ‘no longer pursuing’ nearly 350 acres in Hackett Hill area NEW JERSEY 4 N.J. in Q3 Mergers give hospitals new EHR systems N.J. nursing home scam highlights host of problems | Editorial North Jersey Physical Therapy takes 1,800 sq. near Morristown, Sheldon Gross says NJ hospitals contribute $31.4B

Nursing Homes 40

Nursing Homes Nurses Hospitals Fraud 40

Hall Render

JUNE 7, 2024

million bird flu shots to U.S. million bird flu shots to U.S. million bird flu shots to U.S.

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Hospitals Nursing Homes 40

Hall Render

OCTOBER 25, 2024

Million in Tucson Steward Arizona behavioral hospital gets interim manager Former AZ Department of Health employee charged in Medicaid fraud indictment Arizona hospital performs kidney transplant using robotic technology ARKANSAS NIH Director “blown away” by health care efforts in Arkansas Arkansas Gov.

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

OCTOBER 6, 2023

government grant for maternal health care Alabama slides to 50th on nursing home and long-term care report card Ascension sells Alabama hospital Ascension St. medical school to revamp philanthropic efforts Sage Health opening 3 central Md.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

OCTOBER 6, 2023

government grant for maternal health care Alabama slides to 50th on nursing home and long-term care report card Ascension sells Alabama hospital Ascension St. medical school to revamp philanthropic efforts Sage Health opening 3 central Md.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

APRIL 29, 2022

Alabama Medicaid enrollment increases as pandemic requirement continues. California to increase awards in medical malpractice cases. in malpractice case. Hawaii begins COVID-19 ‘Transition Plan’ Maui hospital system still reliant on funds from government. Pandemic uncertainty complicates Medicaid budget.

COVID-19 40

COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40

Hall Render

MAY 10, 2024

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ biotech mulling sweetened acquisition offer D.C.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Hall Render

JULY 22, 2022

Delaware Adds Centene Plan to Medicaid Managed Care Offerings. Key advocates reflect on Hawaii postpartum Medicaid coverage extension. State settles University of Iowa medical malpractice lawsuit for $7.5 Hospital System Says It’s Hurt by Lack of Medicaid Expansion. Ground broken for Milton medical pavilion.

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

Hall Render

SEPTEMBER 22, 2023

in repairs Sutter Health faces possible $519M payout in alleged double billing case COLORADO Denver Health sued by sons after father’s jail death How a Kaiser Permanente worker strike could affect Colorado patients Kaiser names regional president Medical Office Building in Littleton Sells for $6.1M

COVID-19 40

COVID-19 Nursing Homes COVID-19 Vaccine Nurses 40

Hall Render

MARCH 1, 2024

Reeves doesn’t mention Medicaid expansion or health care crisis in State of the State address U.S. KXAN investigates Does UT Tyler Health Science Center’s deal with private equity shield doctors from malpractice suits? R1 RCM posts $3.3M R1 RCM posts $3.3M Monopolizes Care Physician charged in $20.7M

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses Hospitals 40

Hall Render

JULY 21, 2023

Luke’s hospital doubles its square footage in McCall Teton Valley Health recruits new CEO from neighboring hospital New national 988 suicide and crisis lifeline helps more Idahoans In Idaho, Half of People Removed From Medicaid Didn’t Send State Their Info ILLINOIS HSHS St. Luke’s named to Becker’s Great Heart Programs list Univ.

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Hospitals Nursing Homes 40

Hall Render

FEBRUARY 10, 2023

Dunleavy proposes extending Medicaid coverage for new mothers ARIZONA Banner Health pays $1.25M penalty over HIPAA failures from 2016 breach Arizona nursing school at risk of losing accreditation St. billion since pandemic U.S. billion since pandemic U.S. Luke’s Health System says it will lay off workers in Idaho.

US Department of Health and Human Services 40

US Department of Health and Human Services COVID-19 Nursing Homes Nurses 40

Hall Render

DECEMBER 22, 2023

governor pushes new Medicaid expansion proposal with work requirement Missouri state senator wants voters to have say in KU Health System, Liberty Hospital merger Kansas ACLU request to halt excessive wait times at Larned turned down by judge ‘Who cares about us? health care spending hits $4.5

Nursing Homes 40

Nursing Homes Nurses COVID-19 Hospitals 40

Hall Render

NOVEMBER 17, 2023

Jill Biden will lead new initiative to boost federal government research into women’s health Joint Commission says acute, critical access hospitals must join safety network Lawsuit claims UnitedHealth AI wrongfully denies elderly extended care Most Rural U.S. Compensation is key Is spine surgery expansion next for ASCs?

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40