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With its focus on preventing fraud, waste, and abuse (FWA) within the healthcare system, OIG healthcare compliance sets standards that every healthcare provider should be aware of. Schedule a Demo See the software that makes getting compliant a breeze! Schedule Now × Schedule a Demo Find Out More! Please Wait.
Mitigating Legal Risks The healthcare industry is subject to numerous laws and regulations that govern everything from billing practices to data security. These policies should cover areas such as privacy protection, code of conduct for employees, anti-fraud measures, and reporting mechanisms for violations.
These regulations and laws help maintain patient confidentiality, ensure quality care, and prevent fraud and abuse within the healthcare industry. These requirements are designed to protect patient rights, privacy, and safety, as well as to prevent fraud, abuse, and other improper practices within healthcare organizations.
Understanding Healthcare Regulatory Compliance: Unraveling the Complexities Healthcare regulatory compliance refers to the adherence to laws, rules, and guidelines set by authorities that govern the delivery of healthcare services. Schedule a Demo See the software that makes compliance management a breeze! Find Out More! Please Wait.
These exclusions are generally related to criminal activity like fraud or healthcare-related misconduct. Felony convictions for other healthcare-related fraud, theft, or other financial misconduct. Read more about the rollout and accountability of requirements or schedule a demo. . Patient abuse or neglect.
Backed by FACIS ® ( Fraud Abuse Control Information System ), the most comprehensive data platform in the healthcare industry, the accuracy of Verisys’ screening, verification, and monitoring services exceeds the standard set by the Office of Inspector General (OIG). Verisys was created over 30 years ago to address this very issue.
That is, until there is a fine, civil monetary penalty, or public lawsuit caused by patient negligence or fraud. A continuous data monitoring program such as Verisys is necessary to meet and exceed state and federal requirements for participation in government-funded programs.
Healthcare compliance refers to the process of adhering to the laws, regulations, and ethical standards that govern the healthcare industry. It also helps prevent fraud, abuse, and errors, ensuring the delivery of high-quality care and ethical decision-making. Contact us today to schedule a free demo.
The False Claims Act Unveiled The False Claims Act (FCA) is a linchpin in the government’s efforts to combat fraud against federal programs, including healthcare programs. Get a Demo The post Navigating the Regulatory Landscape and Decoding HHS Guidance on Health Regulations appeared first on Compliancy Group.
What Do Internal and External Medical Audits Looks Like Internal audits can often range from: Clinical Audits Random Audits Federal Government Audits Commercial Payer Audits Quality Improvement Audits Operational Audits Each audit will have a different purpose. Start with a demo today.
They review healthcare claims and billing practices to ensure accuracy, detect fraud or abuse, and assess compliance with the payer’s policies and guidelines. Federal Government Audits These audits are performed by government agencies such as the Centers for Medicare and Medicaid Services (CMS).
MCOs must adhere to federal (Medicare) and state (Medicaid) laws and regulations governing the healthcare industry. These include laws related to insurance, healthcare privacy (HIPAA), billing practices, and fraud and abuse prevention. Schedule a free demo today and learn how! Quality of Care Standards.
A healthcare compliance company helps providers and organizations adhere to the complex and ever-changing regulations and standards that govern the healthcare industry. The main goal of a healthcare compliance company is to reduce and prevent fraud, waste, and abuse. Don’t let compliance fall by the wayside.
Listen to a candid discussion on lessons learned from the 2023 federal investigation that uncovered fraudulent medical practice nationwide in this on-demand webinar: Moving Forward From the Nursing Fraud Scheme. Schedule a free demo today to see for yourself how easy Medtrainer makes credentialing — and how easy it is to reap the benefits.
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This practice brings tremendous government oversight, and misuse of samples can lead to penalties, fines, and even imprisonment. Maintaining a tightly controlled, highly compliant call deck for pharmaceutical reps prevents sampling fraud and protects the company’s employees. Set up an appointment today to learn more.
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