This site uses cookies to improve your experience. To help us insure we adhere to various privacy regulations, please select your country/region of residence. If you do not select a country, we will assume you are from the United States. Select your Cookie Settings or view our Privacy Policy and Terms of Use.
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Used for the proper function of the website
Used for monitoring website traffic and interactions
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Strictly Necessary: Used for the proper function of the website
Performance/Analytics: Used for monitoring website traffic and interactions
Its often the hidden costs that sneak up with the biggest impact to revenue and compliance. Download Now How Bad Data Leads to Financial Losses Revenue loss from poor provider data management mistakes is largely driven by denied claims, billing errors, and enrollment delays.
Enrollment delays cost nearly a third of organizations polled in a 2023 MedTrainer survey money, and 26% believe credentialing delays increase compliance risks that can significantly drain coffers. Download our Credentialing Reality Worksheet to find out! How much are enrollment delays costing your organization?
OIG exclusion list monitoring is vital in maintaining compliance with Centers for Medicare & Medicaid Services (CMS) regulations, as well as National Committee for Quality Assurance (NCQA) credentialing standards , among other federal healthcare provisions. We wouldnt either. Be ready for inspections from OSHA, OCR, CMS, and OIG.
If you think about it, healthcare compliance can be comparable to juggling chainsaws in the sense that both require a high level of skill, focus, and precision. Think about your organization as the big top, and all of the responsibilities you have as the compliance officer are your chainsaws!
Those early ethical standards paved the way for how medical compliance plans to limit liability for healthcare organizations today. Here’s how these plans help limit liability: Prevent Fraud and Abuse: Compliance plans include measures to prevent fraud and abuse within the healthcare organization. HIPAA in the U.S.),
But the best tool to prevent small practice cybercrime can be as basic as having a truly effective HIPAA compliance strategy. For HIPAA compliance to help prevent small practice cybercrime, it must address the particulars of your practice. The most common “download and start” version used by so many people is not HIPAA compliant.
That mean, maintaining compliance standards, efficient reporting, and conducting thorough internal audits are vital. Download “Compliance Reports You Can’t Live Without” for OIG reporting templates and tips. This is done to ensure compliance with regulations, identify areas for improvement, and assess program effectiveness.
But malpractice claims, license actions, and disciplinary measures dont work on your schedule. By consolidating verification efforts through credentialing software, teams can work proactively, reduce manual work, and strengthen compliance all while protecting their bottom line. Lag time increases risks exponentially.
As organizations strive to maintain the highest standards of care, adopting the best healthcare credentialing software is a strategic move that enhances operational efficiency and ensures compliance with industry regulations. Download the guide to Essential Credentialing Data.
Its what makes tracking and reporting a critical part of compliance and accreditation. Luckily, MedTrainers credentialing platform puts all your data in one location with highly-customizable reports to simplify compliance with NCQA credentialing standards. If its not documented, it didnt happen. Get in touch!
Additionally, the credentialing specialist may request a record of any pending and past medical malpractice cases and disciplinary actions from the appropriate authority. Download Now What are Provider Privileges? Meets compliance standards: Both processes verify a provider has met compliance standards.
Download 5 Ways To Improve Your Credentialing Process. While many healthcare organizations still rely on manual or decentralized credentialing processes, the potential for verification errors could compromise patient safety and organizational compliance. Fill in this worksheet to determine how many hours your enrollments should take.
Additionally, navigating the complex and frequently changing regulations and standards increases the risk of non-compliance, potentially leading to legal and liability issues. Compliance with Regulatory Requirements Healthcare organizations are legally responsible for verifying that all providers are properly credentialed and privileged.
Download Now Common Challenges in Behavioral Health Credentialing Where behavioral health credentialing diverges from typical provider credentialing is Medicare enrollment. This may include proof of licensure, certification, accreditation, malpractice insurance, DEA registration (if applicable), and other supporting documentation.
Familiarize yourself with any payer-specific requirements such as proof of malpractice insurance, state-approved alternatives, and specific forms like the special needs survey or disclosure of ownership statement. Identify whether you are submitting an individual, group, or delegated application to avoid confusion.
Written by: Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, COCAS, CORCM, OHCC, ICDCT-CM/PCS This article addresses how to track telehealth policies while addressing HIPAA compliance and mobile device management as the United States enters into a post-pandemic era. What Additional Information Should I Know for Compliance?
Download Now Common Challenges in ASC Credentialing Revenue is of critical importance in an ASC. Credentialing Delays: The credentialing process can be lengthy, often involving gathering and verifying extensive documentation, including education, training, licensure, certifications, malpractice history, and references.
The policy issuer for malpractice insurance verifies insurance coverage. Delivery of data ranges from a print-out sent by mail, a spreadsheet sent through email, a CSV download from a secure server, or an online searchable database. The Primary Source Organizations. Some organizations compile and publish data monthly. Unpublished Data.
The policy issuer for malpractice insurance verifies insurance coverage. Delivery of data ranges from a print-out sent by mail, a spreadsheet sent through email, a CSV download from a secure server, or an online searchable database. The Primary Source Organizations. Some organizations compile and publish data monthly. Unpublished Data.
Legal Implications: The landscape of medical malpractice and legal liability is intrinsically linked to reporting. Download Now Build a Reporting Culture Organizational culture is one of the most challenging aspects of healthcare incident reporting. Technology can make it much easier for employees to maintain compliance.
Contact your risk attorney through your malpractice insurance company for guidance which is obtained through no additional cost (part of the service you get when paying the insurance premium). Download the CMS Model Notice and Consent forms. Know your state laws and when Federal laws supersede state rules. Identify eligible cases.
Written by Joanne Byron , BS , LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS of the American Institute of Healthcare Compliance (AIHC), a non-profit healthcare education organization. The effective date of the Final Rule was June 25, 2024 with a compliance date of December 23, 2024. What is this Final Rule?
We organize all of the trending information in your field so you don't have to. Join 26,000+ users and stay up to date on the latest articles your peers are reading.
You know about us, now we want to get to know you!
Let's personalize your content
Let's get even more personalized
We recognize your account from another site in our network, please click 'Send Email' below to continue with verifying your account and setting a password.
Let's personalize your content