Healthcare IT Today

NOVEMBER 15, 2023

The previous article in this series explained some of the ways payers, providers, and digital health companies demonstrate that they have made a positive difference in their patients’ lives. ” This article looks at the measurements and reporting strategies used by some specific companies. offering in-home treatment.

Medicare 124

Medicare Medicare Hospitals Compliance 124

MRO Compliance

OCTOBER 23, 2023

This transformation aims to enhance patient care quality and better align ACO reporting with the Quality Payment Program (QPP) Merit-Based Incentive Payment System (MIPS). These organizations received concessions from CMS to serve as early adopters and test the system. But other ACOs are only just getting started.

Payment Systems 130

Payment Systems Medicare Medicare 130

Healthcare IT Today

JUNE 29, 2023

The following is a guest article by Isaac Smith, Billing, Coding, and Reimbursement Specialist at Medcare MSO ASCs are types of medical facilities that are subject to stringent regulations. However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance. Two other appendices apply to ASCs.

Compliance 52

Compliance Medicare Medicare Medical Billing 52

Healthcare IT Today

NOVEMBER 12, 2023

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Health Payment Systems selected Madaket Health to manage its provider directory and roster requirements for No Surprises Act compliance.

Public Health 97

Public Health Payment Systems Medicare Medicare 97

Healthcare IT Today

NOVEMBER 14, 2022

The following is a guest article by Brian Marsella, President at HPS/Paymedix. Employees on employer-sponsored plans also now have to deal with multiple invoices from different providers for deductibles and other payments. In fact, according to data from Health Payment Systems (HPS), the average U.S.

Medical Billing 105

Medical Billing Payment Systems Health Insurance HIPAA 105

Hall Render

NOVEMBER 25, 2024

Department of Health and Human Services (“HHS”) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (“Nursing Facility ICPG”) for nursing home members of the health care compliance community. On November 20, 2024, the Office of Inspector General (“OIG”) for the U.S.

Nurses 40

Nurses Compliance Compliance Officers Medicare 40

Medisys Compliance

JULY 19, 2024

Understanding these updates is crucial for behavioral health providers to ensure compliance, maximize reimbursements, and continue delivering high-quality care. This article discusses the latest changes, providing a comprehensive guide to navigating the evolving billing landscape.

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Medicaid Medicaid Medicare Medicare 52

Healthcare IT Today

MAY 9, 2024

Healthcare providers, technology companies, and regulated lenders can collaborate to drive digital transformation and financing accessibility while meeting regulatory and compliance standards and protecting the patient’s financial well-being.

Patient Satisfaction 84

Patient Satisfaction Payment Systems Compliance Governance 84

Medisys Compliance

APRIL 25, 2024

This article aims to simplify the impact of MACRA on your cardiology billing, empowering you to navigate these changes with confidence. MACRA replaced the previously used Sustainable Growth Rate (SGR) formula for Medicare physician payments. We offer a comprehensive suite of services designed to streamline MACRA compliance.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Medicare Medicare 64

Medisys Compliance

MARCH 14, 2023

In this article, we shared wound care reimbursements in certain healthcare facilities. Wound Care Reimbursements in Various Healthcare Settings Inpatient Hospital Wound care in an inpatient hospital setting is reimbursed through the Diagnosis-Related Group (DRG) payment system.

Payment Systems 52

Payment Systems Medical Billing Medicare Medicare 52

Healthcare IT Today

FEBRUARY 2, 2024

The following is a guest article by Tom Magnotta, COO & President at Apixio Albert Einstein famously said , “Whoever is careless with the truth in small matters cannot be trusted with important matters.” In adopting pre-payment systems, the synergy between payers and providers is paramount.

Payment Systems 78

Payment Systems Overpayments Overpayment Medical Billing 78

AIHC

NOVEMBER 15, 2022

Compliance is mandatory. However, a low compliance level among hospitals would compromise the operational effectiveness of this regulation. Understanding hospitals’ compliance status to the regulation has important implications for its enforcement effort and effectiveness assessment. So, exactly what is this all about?

Hospitals 52

Hospitals US Department of Health and Human Services Compliance Governance 52

Hall Render

FEBRUARY 14, 2025

See our previous article here. 424.527(a) in the “Calendar Year (CY) 2024 Home Health (HH) Prospective Payment System Rate Update” final rule to address this issue. Ensure Compliance Before Reactivating: Providers seeking reactivation should conduct a thorough internal audit before submitting their application.

Medicare 52

Medicare Medicare Compliance Payment Systems 52

Hall Render

MARCH 1, 2023

During the Dispute Period, Covered Recipients may use CMS’ Open Payments system to formally dispute any information they believe is incorrect. If a Covered Recipient fails to dispute data reported in the system during the Dispute Period, the information will be published on June 30 th as originally reported.

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Hospitals Payment Systems Nurses Medical Device Industry 40

Healthcare IT Today

MAY 22, 2023

The following is a guest article by Jon Zimmerman , CEO at Holon Solutions In today’s healthcare landscape, clinical information systems are valuable tools for coordinating care and improving outcomes. Payers have to manage complex payment systems, track performance, and ensure regulatory compliance.

Regulatory Compliance 88

Regulatory Compliance Payment Systems Compliance Hospitals 88

AIHC

JANUARY 28, 2022

For more information on filing compliance cost reports, attend the Medicare Cost Report Camp in March 2022 presented by KraftCPAs and sponsored by the American Institute of Healthcare Compliance. LTCHs are paid under the Long-Term Care Hospital Prospective Payment System (LTCH PPS).

Medicare 40

Medicare Medicare Hospitals Payment Systems 40

Compliancy Group

JUNE 28, 2024

This article covers the disincentives that can be imposed on a provider found to have engaged in information blocking. For CAHs, payment will be reduced to 100 percent of reasonable costs instead of 101 percent.

Medicare 59

Medicare Medicare Hospitals HIPAA 59

AIHC

NOVEMBER 29, 2023

We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. In 1983 Medicare shifted to the inpatient Prospective Payment System (PPS) and DRGs (Diagnostic Related Groups) and only paying a limited number of days to the hospital regardless of the actual length of stay.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Hall Render

FEBRUARY 24, 2022

New Natures of Payment Categories. CMS has identified 78 different categories, referred to as “natures of payment,” into which reportable transfers of value may fall. In order to lodge a formal complaint, Covered Recipients must be registered on the Open Payments system.

Hospitals 40

Hospitals Payment Systems Nurses Compliance 40

AIHC

NOVEMBER 29, 2023

We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. In 1983 Medicare shifted to the inpatient Prospective Payment System (PPS) and DRGs (Diagnostic Related Groups) and only paying a limited number of days to the hospital regardless of the actual length of stay.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

MARCH 20, 2024

The Final Rule also imposes additional reporting requirements under the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals and for eligible clinicians reporting under the Promoting Interoperability performance category of the Merit-Based Incentive Payment System.

Medicare 40

Medicare Medicare Health Insurance Medicaid 40

Hall Render

AUGUST 27, 2024

The Centers for Medicare & Medicaid Services (“CMS”) will publish the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) in the Federal Register on August 28 with an effective date of October 1, 2024. CMS estimates this extension will result in $137 million in additional payments to IPPS hospitals.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

HIPAA Journal

FEBRUARY 9, 2024

This article discusses the seven most common benefits. Patient scheduling software most often consists of a cloud-based appointment booking platform which integrates with a healthcare organization’s practice management system and EHR system. How Does Patient Scheduling Software Work?

HIPAA 40

HIPAA Compliance Payment Systems Ransomware 40

Physician Credentialing Company

OCTOBER 25, 2024

In this article, we will discuss detailed information regarding what the 90834 CPT code means, who can assign it, and the services covered by it. Medicare and Medicaid may have different payment systems from those of the private health insurance plans. They should also be informed when they are close to the set limit.

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

Hall Render

MAY 2, 2023

CMS expects all providers to be in compliance with the requirements for PASARR with all admissions taking place after May 11, 2023. Hall Render blog posts and articles are intended for informational purposes only. The F-Tag associated with this regulation is F-884. The CMS Memo confirmed that this waiver will end at the end of the PHE.

Nursing Homes 40

Nursing Homes Public Health Nurses COVID-19 40

Hall Render

NOVEMBER 28, 2023

On November 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update Final Rule (“2024 Final Rule”), which has since been filed in the Federal Register. Hospices need to be much more vigilant about compliance.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

HIT Consultant

SEPTEMBER 7, 2021

Hospitals and providers should also verify that their billing systems are not automatically assigning patient balances under circumstances that prohibit it under the No Surprises Act. Lean into the regulations to go above and beyond compliance. About Ogi C. Kwon, JD, MHA. References. anesthesia and radiology).

Medical Billing 52

Medical Billing Hospitals Medicaid Medicaid 52

Hall Render

DECEMBER 23, 2024

In June 2024, CMS released a memo that restated to state survey agencies that Plans of Correction are an element of the compliance review but are ultimately no more than an allegation of compliance and signal the providers readiness for revisit. SNF Prospective Payment FY 2025 and Expansion of Authority for Enforcement of CMPs.

Nursing Homes 40

Nursing Homes Nurses Compliance Medicare 40

Drug & Device Law

JULY 31, 2023

The now-venerable Restatement (Second) of Torts §402A (1965), describes “products” as “chattels” or “articles.” The 2005 revisions to Article 2 excludes “information” from the definition of goods and also defines computer software as “information.” Digital files were not “articles,” which must be “material things.” at 1291-92.

Governance 52

Governance Payment Systems Hospitals Licensing 52