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From small clinics to expansive hospital systems, healthcare providers must navigate a complex web of federal, state, and local regulations designed to protect patient care. Shockingly, over $54 billion is stolen each year through scams targeting patients and insurance companies with fraudulent medical charges, according to the NHCAA.
MAOs must prepare for heightened regulatory scrutiny by implementing robust complianceframeworks, increasing retrospective chart reviews, and enhancing coding accuracy. While HIPAA is a law and provides regulations, there’s no formal certification process for compliance right now, which leaves a real gap.
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