Verisys

MARCH 6, 2025

What Is AI in Healthcare Compliance? Imagine having a tireless assistant who handles the nitty-gritty of regulatory compliance so healthcare teams can focus on what matters mostpatient care and privacy. AI in healthcare compliance taps into the power of machine learning, natural language processing, and automation.

Compliance 52

Compliance US Department of Health and Human Services Regulatory Compliance Fraud 52

Compliance Now

JANUARY 3, 2022

This requirement is designed to facilitate the plan sponsor’s compliance as a fiduciary to ensure that compensation is reasonable and that no conflicts of interest exist for plan service providers. Is this definition limited to service providers who are licensed as, or who market themselves as, “brokers” or “consultants”?

Compliance 188

Compliance Licensing 188

Healthcare IT News - Telehealth

JANUARY 9, 2023

But even if some important questions about virtual care's staying power have been answered recently , health systems and telehealth startups continue to face major challenges navigating licensing requirements to operate across state lines. Not only does this process create inefficiencies and confusion, but mistakes can be very costly.

Telemedicine 188

Telemedicine Licensing Compliance COVID-19 188

Healthcare It News

AUGUST 9, 2023

Large language models frequently demonstrate the tendency to memorize contents of their training data, which can risk patient privacy in the context of models trained on sensitive health information. Does Med-PaLM 2's training corpus include protected health information? If so, how is the disclosure presented?

Licensing 246

Licensing Hospitals Health Outcomes Governance 246

Hall Render

NOVEMBER 1, 2024

Thus, this case serves as a reminder of the potential for severe consequences for health care fraud, including imprisonment, hefty fines and the loss of a medical license. As such, providers should prioritize billing compliance. Hall Render blog posts and articles are intended for informational purposes only.

Fraud 40

Fraud Compliance Medicaid Medicaid 40

MRO Compliance

JUNE 1, 2022

Information You Need to Know about a HEDIS Audit from Revenue Cycle Experts. Each year HEDIS rating criteria is updated, meaning your organization needs to stay up-to-date on the latest news and trends for HEDIS compliance audits. This information becomes increasingly valuable to providers during payer contract negotiations.”

Medicare 130

Medicare Medicare Compliance Medicaid 130

MedTrainer

DECEMBER 17, 2024

Thats why MedTrainer maintains a strong commitment to product innovation, constantly improving features to ensure our customers have the cutting-edge tools they need to simplify compliance, streamline credentialing, and enhance learning management. Stay on top of deadlines and keep compliance moving. This works for dashboards, too!

Licensing 52

Licensing Compliance Compliance Officers 52

Healthcare IT News - Telehealth

JANUARY 21, 2025

"As part of the technology implementation, we shared information specific to our facility, such as staff lists, contact numbers, medications, supplies and equipment available to them. This has reduced our expenses while maintaining compliance with regulatory requirements for physician oversight.

Telemedicine 175

Telemedicine Hospitals Nurses Regulatory Compliance 175

MedTrainer

MAY 31, 2024

Healthcare compliance is at a tipping point. To handle the ever-growing workload, healthcare compliance professionals must embrace technology. Automation can reduce the redundant administrative tasks and broken processes that plague compliance — at a significant time and cost savings. What is Healthcare Compliance Automation?

Compliance 98

Compliance Licensing Governance Compliance Officers 98

Healthcare IT Today

DECEMBER 2, 2024

The company will scale development to simplify integrating the patient voice across all healthcare activities, while simultaneously automating the manual burden of security and compliance processes needed in the increasingly complex landscape of health data access. Healthcare organizations face new complexities in data use and licensing.

Licensing 73

Licensing Compliance Governance 73

Verisys

MARCH 6, 2025

Credentialing involves a detailed review of a provider’s qualifications, including their: Education Work experience Certifications Licenses Professional standing This process ensures that patients see professionals who are properly trained and certified to provide the level of care they require.

Licensing 52

Licensing Compliance Nurses Malpractice 52

MedTrainer

MARCH 27, 2025

Its often the hidden costs that sneak up with the biggest impact to revenue and compliance. More often than not, provider ineligibility means that incorrect information was submitted. The obvious financial hits come in the form of claim denials, write-offs, and compliance penalties.

Licensing 52

Licensing Malpractice Compliance 52

Healthcare IT News - Telehealth

JUNE 9, 2022

License and approval. Only licensed physicians are qualified and permitted to engage in medical practice. engaging a qualified general compliance manager for marketing). A key factor in determining whether an activity constitutes a "medical practice" is whether medical judgments and techniques are involved.

Licensing 192

Licensing Telemedicine Governance Compliance 192

Healthcare IT Today

MARCH 26, 2025

As the sector adapts, telehealth providers must navigate new compliance challenges, particularly regarding controlled substances, data privacy, and multi-state licensing. Telehealth providers must align with organizations like LegitScript , which certifies compliance with regulatory standards.

FDA 52

FDA Compliance Licensing Fraud 52

Healthcare IT Today

OCTOBER 8, 2024

Most of the data that we are looking to share is highly sensitive health information, the kind of information that cybercriminals love to hold for ransom. We believe that the best way to protect that information is to not store it. So not only is it highly sensitive, it is also highly sought-after.

US Department of Health and Human Services 124

US Department of Health and Human Services HIPAA Regulatory Compliance Public Health 124

AIHC

DECEMBER 27, 2024

Informed consent is a cornerstone of ethical medical practice. of them expressed a correct understanding of what constitutes informed consent. [3] Thus, the implied consent approach undermines the ethical principle of informed consent by creating a significant gap in the important communication process.

Informed Consent 98

Informed Consent Bioethics ADA Medical Personnel 98

Verisys

APRIL 3, 2025

As a centralized hub of critical practitioner data, the NPDB serves as a powerful ally in provider credentialing , helping hospitals, medical boards, and institutions verify backgrounds, track malpractice claims, and ensure regulatory compliance. Other adverse actions Things like voluntarily giving up a license while under investigation.

Malpractice 52

Malpractice Licensing Compliance Hospitals 52

Verisys

APRIL 3, 2025

Faster onboarding, fewer healthcare compliance risks, and more time spent on patient carenot paperwork. In traditional credentialing, healthcare organizations manually collect and verify information from licensing boards, medical schools, and past employersa process that can take a significant amount of time to complete.

Licensing 52

Licensing Malpractice Compliance Nurses 52

HIT Consultant

NOVEMBER 21, 2021

Information exchange and data availability are now a cost of doing business but establishing a robust strategy for that exchange and compliance with the new regulation from the Office of the National Coordinator for Health Information Technology takes careful planning. Understand what constitutes “Electronic Health Information”.

Public Health 98

Public Health Compliance HIPAA Governance 98

Verisys

APRIL 3, 2025

However, the process itself can be complicated and time-consumingand when things go wrong, it can lead to financial setbacks, medical standard compliance issues, and unnecessary stress. Poor communication between departments : Credentialing requires input from many players, including HR, compliance teams, and insurance payers.

US Department of Health and Human Services 52

US Department of Health and Human Services Licensing Compliance Malpractice 52

HIT Consultant

MARCH 30, 2025

When staff members spend excessive time investigating and correcting denied claims, it prevents them from performing higher-value tasks and operating at the top of their license. AI offers a path to stabilize operations and increase revenue while allowing staff to operate at the top of their license.

Regulatory Compliance 66

Regulatory Compliance Licensing Health Outcomes Compliance 66

Healthcare IT Today

OCTOBER 25, 2024

Bluesight , the leading provider of Medication Intelligence solutions for health systems and hospital pharmacies, announced the acquisition of Sectyr , a top-tier compliance and audit management platform. There’s a clear need for better tools to ensure compliance and conduct audits.

Compliance 70

Compliance Regulatory Compliance Hospitals Licensing 70

Verisys

APRIL 2, 2025

How to Acquire a Pharmacy License The process of becoming a licensed pharmacy can be complex even if you have experience, as every state has different documentation requirements. Pharmacies must obtain all the necessary licenses to meet the necessary professional standards before they can legally begin operation.

Licensing 52

Licensing Compliance Medicaid Medicaid 52

Compliancy Group

DECEMBER 25, 2024

Credentialing software can help you automate the tracking of your staff while navigating the complexities of healthcare compliance laws. These records include the medical licenses, certifications, and other credentials practitioners need to hold their jobs. What’s the Purpose of Credentialing Software?

Compliance 52

Compliance Compliance Officers Licensing Doctors 52

Verisys

MARCH 6, 2025

Similarly, insurance companies that process thousands of claims daily require up-to-date provider information to avoid claims delays and denials. Healthcare executives and compliance officers must consistently update and verify provider data to enhance patient care, adhere to regulatory standards, and streamline administrative tasks.

Compliance 52

Compliance Licensing Doctors Malpractice 52

MedTrainer

FEBRUARY 27, 2025

If the payer spots a known exclusion or out-of-date license, its a guaranteed denial. For credentialing professionals verifying licenses or exclusions one by one, continuous monitoring is nearly impossible. If a license validation, download license and add to your file. It doesnt take much for a claim to be denied.

Licensing 52

Licensing Compliance Hospitals 52

MedTrainer

MAY 9, 2024

This is the fourth year MedTrainer has been honored for its compliance management solution, along with 2018, 2020, and 2021. The recognition highlights the consistency of MedTrainer’s compliance software solutions for U.S. healthcare organizations. MedTrainer was founded for healthcare organizations; our focus has never wavered.

Compliance 98

Compliance Licensing 98

MedTrainer

MAY 3, 2024

Non-compliance with these regulations can result in jail time, large fines, and even loss of license. Keeping compliance and fraud prevention top of mind can help to protect both your organization and its staff. Here are four ways healthcare compliance software simplifies fraud prevention: 1.

Fraud 94

Fraud Compliance Compliance Officers Licensing 94

Verisys

FEBRUARY 10, 2025

These changes are designed to enhance patient safety, data accuracy, and compliance efficiency for health plans. At Verisys, we specialize in credentialing and license monitoring , offering industry-leading data accuracy and real-time insights. Key NCQA 2025 Compliance Changes 1.

Licensing 40

Licensing Compliance Medicaid Medicaid 40

Verisys

FEBRUARY 6, 2025

Healthcare provider credentialing solutions help automate and simplify this process, ensuring efficiency and compliance. Nurses have their own credentials, including verifying their nursing license, specialized certifications, and continuing education credits.

Licensing 52

Licensing Nurses Malpractice Compliance 52

MedTrainer

MARCH 31, 2025

March 31, 2025 MedTrainer, a leading provider of healthcare workforce compliance and credentialing solutions , is rapidly releasing innovations that are moving its healthcare workforce compliance platform to the top of the provider credentialing market. LAS VEGAS, Nev.,

Compliance 52

Compliance Licensing 52

Total HIPAA

MAY 23, 2022

What is Protected Health Information (PHI)? In the early 1990s, it became clear that computers and digital records would play a large role in storing health data and that something should be done to protect sensitive information. Therefore, understanding how to handle PHI is essential for achieving HIPAA compliance.

HIPAA 98

HIPAA Due Diligence Health Insurance Compliance 98

MedTrainer

MARCH 6, 2025

Without a proactive approach, delays can quickly spiral, leading to provider shortages, compliance risks, and revenue disruptions. Start Early: Begin gathering provider information and verifications as early as possible. Be Prepared for the Credentialing Summer Surge The key to managing the summer credentialing rush is preparation.

Compliance 52

Compliance Licensing 52

Medisys Compliance

DECEMBER 24, 2024

Medicare Reimbursement Medicare covers teletherapy under specific guidelines: Eligible Providers: Includes licensed clinical social workers (LCSWs), clinical psychologists, and other licensed professionals. Check state-specific Medicaid guidelines to ensure compliance. the patients location or the use of specific technology).

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicaid Medicaid Medical Billing 59

Healthcare Blog

DECEMBER 20, 2024

Or is it managing the information that drives care coordination? Healthcare organizations face the challenge of managing vast amounts of critical documentation, including compliance documents, regulatory forms, and policy updates. Is it delivering high-quality care? Is it medical expertise? All of which put patient safety at risk.

Compliance 52

Compliance Regulatory Compliance HIPAA Licensing 52

MedTrainer

FEBRUARY 16, 2023

Compliance is critical in the medical field, especially during times of high healthcare staff turnover. Even as people and roles change, compliance guidelines stay the same, and serve to help healthcare organizations adhere to legal, ethical, and regulatory standards.

Compliance 98

Compliance Nurses Compliance Officers Licensing 98

Healthcare It News

JUNE 28, 2024

You wouldn't walk into an interview unprepared, but for physicians, that's the norm, and patients can tell when they have to reshare the exact information they filled out at home or in the waiting room. What's more, when doctors are well-informed about their patients, it has the capacity to improve the visit.

Doctors 325

Doctors Licensing Nurses Compliance 325