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When you work in healthcare, you must comply with the most rigorous regulations that safeguard patient health and privacy, protect workers, and prevent fraud, waste, and abuse of federal funds. Anyone in this industry should know the healthcare compliance laws and regulations that guide how they do their jobs and provide quality care.
HIPAA is an acronym for the HealthInsurance Portability and Accountability Act. When the HealthInsurance Portability and Accountability Act was passed by Congress in 1996, the establishment of federal standards for safeguarding PHI was not one of the primary objectives. What is HIPAA? What is HIPAA Title II?
The passage of HIPAA resulted in multiple benefits for the healthinsurance industry, the healthcare industry, and the people that they serve. For example, the Administrative Requirements (Part 162) helped reduce insurancefraud and accelerated eligibility inquiries, authorization requests, and claims processing.
When unauthorized parties gain access to this information, identity theft, fraud, and diminished care often result. Prevent fraud: All parties must comply with laws that prevent fraud and misconduct, such as ordering necessary tests or treatments or billing for services not provided.
Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.
During the 1970s and 1980s, an increasing number of organizations in the healthcare and healthinsurance industries adopted Electronic Data Interchanges (EDIs) to accelerate manual healthcare processes such as eligibility checks, treatment authorizations, and remittance advices.
The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. Compliance in healthcare began to encompass billing, fraud, and abuse prevention. Compliance efforts shifted toward protecting patient information.
By promoting equity and fairness in healthcare delivery, regulations prevent discrimination, ensure equal access to care, and reduce health disparities. Health Information Technology for Economic and Clinical Health Act (HITECH) HITECH is an essential component of the American Recovery and Reinvestment Act of 2009.
The HealthInsurance Portability and Accountability Act of 1996 (HIPAA) was introduced to simplify the administration of healthcare, eliminate wastage, prevent healthcare fraud, and ensure employees could maintain healthcare coverage between jobs. What is HIPAA and Who Does It Apply To? What is considered a HIPAA violation?
Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.
These technologies have become a core function in RCM Operations and have also been adopted by the HealthInsurance, Health System, and Provider communities across the United States. Compliance and Risk Management : Fraud Detection : AI systems can identify unusual patterns that may indicate fraudulent activities.
HIPAA” is the HealthInsurance Portability and Accountability Act of 1996. This federal regulation set standards for safeguarding Protected Health Information , or PHI. HIPAA is regulated by the Department of Health and Human Services (HHS) Office of Civil Rights (OCR). HITECH Act (2009).
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They all have healthinsurance. Orthopedic Associates Surgery Center earns joint replacement accreditation Healthcare-associated violence is under reported, a CT researcher found using AI D.C.
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