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What Is Medical Billing Compliance?

Compliancy Group

One of the most common ways for providers and healthcare organizations to run afoul is to incorrectly or illegally bill and code for services or supplies. No matter the intent, noncompliance in medical billing can have severe consequences. It pays to know the law and avoid temptations to cut corners.

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Lawsuit Alleges Obamacare Plan-Switching Scheme Targeted Low-Income Consumers

Kaiser Health News

In turn, sales agents used the information to either enroll them in ACA plans or switch their existing policies without their consent. Such private sector platforms, which must be approved by the Centers for Medicare & Medicaid Services, streamline enrollment by integrating with the federal ACA marketplace, called healthcare.gov.

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Mary Lou Retton’s Explanation of Health Insurance Takes Some Somersaults

Kaiser Health News

The ACA also includes subsidies that offset all or part of the premium costs for the majority of low- to moderate-income people who seek to buy their own insurance. residents struggle to afford the deductibles, copayments, or out-of-network fees included in some ACA or job-based insurance plans. of household income. 16 in most states.

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Reduced Co-Insurance for Screening Colonoscopies

Medisys Compliance

Section 4104 of the Affordable Care Act (ACA) defined the term ‘preventive services’ to include ‘colorectal cancer screening tests’ and, as a result, it waives any coinsurance that would otherwise apply under Section 1833(a)(1) of the Social Security Act for screening colonoscopies. Background for Reduced Co-Insurance. Reference: [link].

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A Health Consumer Bill of Rights: Assuring Affordability, Access, Autonomy, and Equity

Jane Sarashon

The NIH crafted one for patients enrolled in clinical trials, the American Hospital Association served one up in 1973, and many individual health providers like the University of Pennsylvania Hospital ( aka Penn Medicine) have developed patient bills of rights for consumers entering their hospital systems.

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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

Meeting Medical Billing Compliance Standards Medical billing compliance ensures that providers and administrators engage in ethical and accurate billing practices.

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Her First Colonoscopy Cost Her $0. Her Second Cost $2,185. Why?

Kaiser Health News

The former generally incurs no cost to patients under the ACA; the latter can generate bills. Remind your provider that the government’s interpretation of the ACA requires that colonoscopies be regarded as a screening even if a polyp is removed. Do you have an interesting medical bill you want to share with us?

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