Medisys Compliance

JANUARY 29, 2025

Add in the complexities of Medicare and Medicaid, and it can feel overwhelming. This article will explore how outsourcing cardiology billing for Medicare and Medicaid can streamline your operations, boost revenue, and free you to focus on delivering exceptional cardiac care.

Medicaid 59

Medicaid Medicaid Medicare Medicare 59

Electronic Health Reporter

NOVEMBER 5, 2024

This article is copyrighted strictly for Electronic Health Reporter. The healthcare industry is at a pivotal juncture, with $320 million in Medicare readmission penalties impacting 2,273 hospitals this year alone. Illegal copying is prohibited. By Caroline Hodge, CEO and co-founder, Dimer Health.

Medicare 113

Medicare Medicare Hospitals 113

Electronic Health Reporter

APRIL 4, 2025

This article is copyrighted strictly for Electronic Health Reporter. Illegal copying is prohibited.

Medicaid 91

Medicaid Medicaid Doctors Medicare 91

Healthcare IT Today

NOVEMBER 26, 2024

The following is a guest article by Andrew Mignatti, Co-Founder and CEO at careviso As Medicare annual open enrollment is underway, healthcare providers soon face the overwhelming task of verifying benefits for millions of patients.

Medicare 58

Medicare Medicare Patient Satisfaction Hospitals 58

Electronic Health Reporter

JANUARY 12, 2022

This article is copyrighted strictly for Electronic Health Reporter. The article How To Market to Medicare Patients appeared first on electronichealthreporter.com. The article How To Market to Medicare Patients appeared first on electronichealthreporter.com. Illegal copying is prohibited.

Medicare 133

Medicare Medicare 133

Bill of Health

OCTOBER 17, 2024

This article seeks to summarize these developments in the law. This aligns with recent guidance from the Centers for Medicare and Medicaid Services that Medicare Advantage plans may not make a determination of medical necessity solely based on algorithms using broad data sets. AB 3030 focuses on the use of generative AI.

Medicare 150

Medicare Medicare Health Insurance Licensing 150

Medisys Compliance

FEBRUARY 19, 2025

Billing Update: Medicare Radiology Reimbursement Cuts 2025 Effective January 2025, radiology practices nationwide are facing reduced Medicare reimbursements due to finalized changes in the Physician Fee Schedule. Now, in February 2025, these proposed rules are our current reality. Here are key steps you can take: 1.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

Healthcare IT Today

FEBRUARY 22, 2023

There’s widespread consensus that payments to Medicare Advantage Organizations (MAOs) are a mess. These programs, which care for more than 30 million of the nearly 64 million Medicare enrollees , operate on the cutting edge of health care and suffer serious problems in data collection and billing.

Medicare 118

Medicare Medicare Overpayments Overpayment 118

Healthcare IT Today

DECEMBER 22, 2024

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Welcome to the weekly edition of Healthcare IT Today Bonus Features. That said, rejection rates hit a trough in 2018 and have increased 16% since then.

Medicare 88

Medicare Medicare FDA Telemedicine 88

Healthcare IT Today

NOVEMBER 13, 2024

Contact us here with a link to the open position and we’ll be happy to feature it in next week’s article at no charge! Clinical Integration Analyst – North Memorial Health BI Developer – Phelps Health Director of Information Technology & Project Management – Pueblo Community Health Center, Inc.

Due Diligence 122

Due Diligence Medicare Medicare Hospitals 122

Electronic Health Reporter

APRIL 27, 2023

This article is copyrighted strictly for Electronic Health Reporter. Medicare is a federal health insurance program in the United States that provides coverage to people 65 or older and some younger people with specific disabilities. Illegal copying is prohibited. appeared first on electronichealthreporter.com.

Medicare 103

Medicare Medicare Health Insurance 103

Electronic Health Reporter

MARCH 19, 2021

This article is copyrighted strictly for Electronic Health Reporter. 1, 2020, the Centers for Medicare and Medicaid Services (CMS) released its final ruling on policy and payment changes to the Medicare Physician Fee Schedule […]. Illegal copying is prohibited.

Medicare 171

Medicare Medicare Medicaid Medicaid 171

Healthcare IT Today

NOVEMBER 17, 2024

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Medicare Advantage led the way, with 43% of dollars in downside risk. Welcome to the weekly edition of Healthcare IT Today Bonus Features.

Medicare 92

Medicare Medicare Hospitals 92

Electronic Health Reporter

NOVEMBER 8, 2022

This article is copyrighted strictly for Electronic Health Reporter. With 82% of 2022 claims denials associated with Medicare, and third-party audit volume rapidly climbing, hospitals and health systems are under intense pressure to protect and grow revenues. Illegal copying is prohibited.

Medicare 103

Medicare Medicare Hospitals 103

Electronic Health Reporter

JUNE 26, 2020

This article is copyrighted strictly for Electronic Health Reporter. CMS announced Medicare will nearly […]. CMS announced Medicare will nearly […]. The article CMS Updates Payment For Certain COVID-19 Lab Tests appeared first on electronichealthreporter.com. Illegal copying is prohibited.

COVID-19 172

COVID-19 Medicare Medicare 172

Healthcare IT Today

JANUARY 23, 2025

The following is a guest article by Ashish V. The Medicare Advantage Star Ratings program includes a Health Equity Index (HEI) Reward Factor that will be introduced in 2027 to encourage plans to deliver equitable healthcare. Furthermore, regulators are now mandating that utilization data and effectiveness be reported back to CMS.

Medicare 97

Medicare Medicare Medicaid Medicaid 97

Hall Render

FEBRUARY 17, 2025

According to a statement released on the Center for Medicare and Medicaid Services (CMS) website, effective February 14, 2025, implementation of the Hospice Special Focus Program for calendar year 2025 has ceased so that CMS may further evaluate the program. Hall Render blog posts and articles are intended for informational purposes only.

Medicare 89

Medicare Medicare Nursing Homes Medicaid 89

Electronic Health Reporter

JANUARY 17, 2019

The Patient Driven Payment Model (PDPM) is more than just a new name attached to Medicare payment reform. The article What Is the Patient Driven Payment Model: How Skilled Nursing Providers Can Get Ahead of PDPM appeared first on electronichealthreporter.com. Instead, payment will be determined […].

Nurses 184

Nurses Medicare Medicare 184

Hall Render

JANUARY 29, 2025

The Centers for Medicare & Medicaid Services (CMS) is reinforcing its emphasis on hospice quality of care and identifying fraud. Hospice surveys are performed before their initial certification for Medicare participation. Identifying Fraud : Detecting practices that jeopardize patient safety or Medicare program integrity.

Fraud 80

Fraud Medicare Medicare Compliance 80

MedTrainer

AUGUST 8, 2024

As of March 2024, over 67 million in the United States are Medicare beneficiaries. Medicare is the single largest payer for healthcare services in the United States. In FY2021, the Centers for Medicare and Medicaid Services ( CMS ) reported that Medicare processed more than 1.1 Here’s what you need to know.

Medicare 93

Medicare Medicare Compliance Medicaid 93

Healthcare IT Today

MARCH 5, 2025

Contact us here with a link to the open position and we’ll be happy to feature it in next week’s article at no charge! Do you have an open health IT position that you are looking to fill? Note: These jobs are listed byHealthcare IT Today as a free service to the community.

Due Diligence 112

Due Diligence Medicare Medicare Hospitals 112

Electronic Health Reporter

MAY 10, 2024

This article is copyrighted strictly for Electronic Health Reporter. Illegal copying is prohibited. Intuity Medical, Inc., Intuity Medical, Inc.,

FDA 91

FDA Medicare Medicare 91

Healthcare IT Today

OCTOBER 25, 2024

The following is a guest article by Mike Crouse, Director of Insider Risk at Everfox Ransomware attacks on the healthcare sector continue to grow, with incidents nearly doubling from 2022 to 2023—a concerning figure considering their potential to leave patients in life-or-death situations.

Ransomware 121

Ransomware Hospitals Medicaid Medicaid 121

Medisys Compliance

JANUARY 23, 2025

This article provides a comprehensive overview of telehealth mental health billing updates for 2025, addressing key questions, coding changes, and regulatory updates that impact billing practices. Will Medicare Stop Paying for Telehealth in 2025? However, these extensions come with stipulations.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicare Medicare Medical Billing 59

Healthcare IT Today

OCTOBER 23, 2024

The following is a guest article by David Lareau, CEO at Medicomp Systems A couple of years ago, we predicted an impending “explosion” of Medicare Advantage (MA) fraud and penalties. The Failure of Reactive Approaches The current approach to combating Medicare fraud is woefully inadequate.

Medicare 80

Medicare Medicare Fraud Doctors 80

MRO Compliance

SEPTEMBER 19, 2023

The Centers for Medicare and Medicaid Services (CMS) Medicare Advantage Risk Adjustment Data Validation (RADV) audit season peaks from March through April every year. View Full Article  Health information (HI) professionals nationwide anticipate a looming tsunami of payer requests for medical records.

Medicare 130

Medicare Medicare Medicaid Medicaid 130

Electronic Health Reporter

OCTOBER 19, 2022

This article is copyrighted strictly for Electronic Health Reporter. The article The Inflation Reduction Act: The Impact of Medicare Negotiation of Prescription Drug Prices on Hospitals and Health Systems appeared first on electronichealthreporter.com. Illegal copying is prohibited. In August, H.R.

Prescription Drug Pricing 91

Prescription Drug Pricing Medicare Medicare Hospitals 91

Medisys Compliance

MARCH 21, 2025

Whether you’re working with Medicare or private insurance, understanding how billing units work can significantly impact your reimbursement rates, reduce claim denials, and ensure compliance with payer guidelines. Ignoring Payer-Specific Guidelines: Some private insurance plans deviate from Medicare guidelines.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Medicare Medicare 59

Healthcare IT Today

NOVEMBER 30, 2024

Each week, we’ll be providing a look back at the articles we posted and why they’re important to the healthcare IT community. Five million Americans need to find new Medicare plans in 2025. Welcome to our Healthcare IT Today Weekly Roundup. 3D Printing Improves Surgical Accuracy and Safety, One Layer at a Time.

Medicare 93

Medicare Medicare 93

Healthcare IT Today

OCTOBER 28, 2024

The following is a guest article by Alexander Norell, Senior Director and Global Security Architect at VikingCloud One cannot overstate the benefits of data sharing in healthcare, which grows more prevalent as the years pass and technologies make the process more seamless.

Ransomware 115

Ransomware Compliance Hospitals HIPAA 115

Fierce Healthcare

JULY 30, 2024

As artificial intelligence rapidly makes inroads in healthcare, federal agencies already have the authority to regulator AI at the hospital bedside, according to some healthcare researche | An article published in JAMA Health Forum argues that through the conditions of participation in Medicare and Medicaid, CMS has the authority to oversee how hospitals (..)

Hospitals 133

Hospitals Medicaid Medicaid Medicare 133

Healthcare IT Today

OCTOBER 26, 2024

Each week, we’ll be providing a look back at the articles we posted and why they’re important to the healthcare IT community. Read more… It’s Time to Combat “Instafraud” in Medicare Advantage. Welcome to our Healthcare IT Today Weekly Roundup. Innovation on Full Display at AdvaMed’s MedTech Conference.

Ransomware 95

Ransomware Fraud Licensing Nurses 95

MRO Compliance

MARCH 20, 2023

Three Tech Takeaways from RISE: Health Plans Focus on Engagement, Collaboration and Compliance March 20, 2023 Health IT Answers by Beth Friedman, FINN Partners It has been said that wherever Medicare goes, so do all the rest of the payers. View Full Article

Compliance 130

Compliance Medicare Medicare 130

AIHC

NOVEMBER 12, 2024

This article addresses how these privacy rights extend beyond rules designated under HIPAA and States passing rules banning unauthorized pelvic exams. These revisions resulted from recent articles, media reports, and concerns from nurses, some physicians, and medical students opposing these exams. [3],[4]

Informed Consent 98

Informed Consent HIPAA Compliance Hospitals 98

Healthcare IT Today

OCTOBER 19, 2024

Each week, we’ll be providing a look back at the articles we posted and why they’re important to the healthcare IT community. John summarized a study in the American Journal of Managed Care highlighting how real-time interventional analytics reduced 30-day readmissions and Medicare spending per beneficiary for Penn Medicine affiliates.

Health Insurance 94

Health Insurance Medicare Medicare Hospitals 94

Bill of Health

DECEMBER 27, 2022

A full posting of abstracts/summaries of these articles may be found on our  website. Frequency of Approval and Marketing of Biosimilars With a Skinny Label and Associated Medicare Savings. Getting the Price Right: Lessons for Medicare Price Negotiation from Peer Countries. Beall RF, Glazer T, Ahmad H, et al. Healthcare Policy.

Medicare 147

Medicare Medicare Medicaid Medicaid 147

MRO Compliance

JULY 12, 2023

Accurate, properly documented, interoperable patient data is required to achieve CMS’s goal for 100 percent of Medicare (and the majority of Medicaid) beneficiaries to be enrolled in some type of accountable, or value-based, care arrangement by 2030. View Full Article

Medicaid 130

Medicaid Medicaid Medicare Medicare 130