Healthcare Blog

AUGUST 23, 2023

Schedule a demo today to see how MCN Healthcare’s learning management system can help your organization.! Schedule a demo today to see how MCN Healthcare’s Policy Management Software can help improve your policies and procedures workflows and searchability. link] Centers for Medicare & Medicaid Services. 2022, December 5).

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Compliance Nurses Regulatory Compliance Medicaid 73

Compliancy Group

JUNE 21, 2024

The Office of the Inspector General (OIG) has honed in on chiropractic practices over the last few years because of improper payments and claims, and noncompliance with Medicare requirements. This is especially true if you accept Medicare Managed Care, which requires compliance with Medicare documentation.

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Compliance Compliance Officers Medicare Medicare 52

Compliancy Group

JULY 8, 2024

That’s why it’s essential to understand and apply the Center for Medicare and Medicaid (CMS) Rule for Emergency Preparedness. Each organization must comply with the CMS Emergency Preparedness Rule to participate in Medicare and Medicaid. To this end, your CMS emergency preparedness plan should contain these components.

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Compliance Officers Compliance Medicaid Medicaid 52

YouCompli

MARCH 22, 2023

According to the OIG, prior error rate testing has suggested an improper payment rate of almost 30% for Medicare. For example, the government regularly asserts Medicare claims must be “reasonable and necessary for the diagnosis or treatment of an illness or injury.” Once identified, Medicare should perform audits on those providers.

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Overpayment Overpayments Compliance Medicare 52

YouCompli

JUNE 29, 2022

A measure in the Consolidated Appropriations Act signed into law in March, extended Medicare telehealth reimbursement for 151 days following?the If the Centers for Medicare and Medicaid Services (CMS) continues to expand coverage for telehealth services and provides reimbursement for virtual care, telehealth will continue.

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Compliance Officers Compliance Telemedicine COVID-19 52

Healthcare Blog

OCTOBER 19, 2023

The Centers for Medicare and Medicaid Services has a vast information depository on regulations and guidance for healthcare policy. Set up a demo with MCN today to learn how our policy management software can partner with you to achieve your goals. The OMH helps to improve the health of racial and ethnic minority groups.

Public Health 105

Public Health Compliance Hospitals Health Insurance 105

Compliancy Group

JULY 18, 2023

Schedule a Demo See the software that makes getting compliant a breeze! Schedule Now × Schedule a Demo Find Out More! Please Wait. Something is wrong with your submission. To protect patients and maintain high standards of care, healthcare providers must perform regular OIG background checks on their employees and vendors.

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Fraud Compliance Governance Medicaid 52

Healthcare Blog

FEBRUARY 24, 2025

Let’s explore some of the common obstacles encountered by healthcare organizations, higher education institutions, and businesses: Healthcare Regulatory Complexity: Healthcare organizations must navigate a complex web of federal and state regulations, such as HIPAA, OSHA, state-specific licensing requirements, and Medicare swing bed rules.

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Compliance Nurses HIPAA Governance 52

Compliancy Group

AUGUST 26, 2024

These risks range from privacy protection issues to AI usage within healthcare, Medicare Advantage changes, and third-party risks. For example, the Centers for Medicare and Medicaid Services (CMS) usually will release regulatory modifications annually. Make your compliance approach more sustainable by scheduling a demo today.

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Compliance HIPAA Medicare Medicare 52

Compliancy Group

SEPTEMBER 11, 2023

Entities such as LA Care must protect the health information of its insureds while providing health care for the most vulnerable residents of Los Angeles County through its coverage, which includes Medicaid, Medicare, and Affordable Care Act health plans.” Schedule a Demo See the software that makes getting compliant a breeze!

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HIPAA Compliance Medicaid Medicaid 52

Compliancy Group

JUNE 17, 2024

The Centers for Medicare & Medicaid Services (CMS) has identified that a significant number of improper payments are issued every year. Say goodbye to spreadsheets and hello to automated software See How It Works VIEW DEMO The post How Do CMS Checks in Healthcare Work? appeared first on Compliancy Group.

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Compliance Compliance Officers Medicaid Medicaid 59

MedTrainer

AUGUST 30, 2023

Medicare Advantage (Part C). Medicare Advantage plans are managed care plans offered by private insurance companies as an alternative to traditional Medicare (Parts A and B). MCOs must adhere to federal (Medicare) and state (Medicaid) laws and regulations governing the healthcare industry. appeared first on MedTrainer.

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Compliance Regulatory Compliance Medicaid Medicaid 52

Healthcare Blog

AUGUST 23, 2023

Schedule a demo today to see how MCN Healthcare’s learning management system can help your organization.! Schedule a demo today to see how MCN Healthcare’s Policy Management Software can help improve your policies and procedures workflows and searchability. link] Centers for Medicare & Medicaid Services. 2022, December 5).

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Compliance Nurses Regulatory Compliance Medicaid 52

YouCompli

APRIL 27, 2022

Per the Centers for Medicaid & Medicare Services (CMS), the previous restrictions limiting telehealth mental health services to patients residing in rural areas no longer apply. Read more about our regulatory monitoring process or schedule a demo. Compliance considerations.

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Compliance Officers Licensing Nurses Compliance 52

YouCompli

MAY 11, 2022

In March of 2022, a New Jersey rheumatologist was convicted by a federal jury for defrauding Medicare and other health insurance programs. Medicare generally prohibits healthcare providers from separately billing for E&M services provided on the same day as another medical procedure. Billing for services not needed or received.

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Compliance Officers Fraud Compliance Medicare 52

YouCompli

DECEMBER 7, 2022

The OIG must exclude individuals or entities who have been convicted of the following types of crimes: Medicare or Medicaid fraud, as well as any other offenses related to the delivery of items or services under Medicare, Medicaid, SCHIP, or other state healthcare programs. Patient abuse or neglect.

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Fraud US Department of Health and Human Services Compliance Medicaid 52

MedTrainer

JANUARY 2, 2024

It’s no secret healthcare is rife with policies, regulations, rules, and compliance requirements to ensure patient safety, proper reimbursement by payers including the Centers for Medicare and Medicaid Services (CMS), and adherence to internal policies such as disaster preparedness and mandatory new-hire training.

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Compliance Medicaid Medicaid Medicare 52

MedTrainer

MAY 7, 2024

Schedule your demo to see MedTrainer Credentialing Software in action. Here is a list of the information you’ll need to gather for UnitedHealthcare credentialing: Training and Education Practitioner degree (M.D., Easily assign multiple enrollments to staff, update statuses, and prioritize.

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Malpractice Licensing Medicaid Medicaid 52

Compliancy Group

JUNE 18, 2024

In addition, physicians can be sued for the damages they caused, and facilities that violate EMTALA can be excluded from Medicare eligibility. Say goodbye to spreadsheets and hello to automated software See How It Works VIEW DEMO The post 3 Healthcare Regulations That Could Make or Break Your Practice appeared first on Compliancy Group.

HIPAA 52

HIPAA Compliance Health Insurance Hospitals 52

Compliancy Group

JANUARY 17, 2024

Department of Health and Human Services (HHS), is tasked with combating fraud, waste, and abuse in health programs, ensuring efficiency, and promoting the integrity of HHS programs, including Medicare and Medicaid. Contact us to learn more about our solutions or to request a demo.

US Department of Health and Human Services 52

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

MedTrainer

SEPTEMBER 8, 2023

Details of the settlement indicate the submission of false claims to Medicare, Medicaid, TRICARE, and FECA programs. Many healthcare facilities rely on reimbursements from government programs such as Medicare and Medicaid. To learn more about how these solutions can benefit your organization, contact us for a demo.

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Compliance HIPAA Medicaid Medicaid 52

MedTrainer

OCTOBER 4, 2023

These federal compliance governing agencies regulate the industry at the national level: Centers for Medicare & Medicaid Services (CMS). CMS plays a crucial role in overseeing federal healthcare programs, including Medicare and Medicaid. Schedule a demo and learn more about MedTrainer today!

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Compliance Fraud HIPAA Governance 52

Provider Trust

APRIL 30, 2024

Book a Demo Plus, our data oversight team investigates any potential matches for you at no extra cost, returning exact matches only. Learn more about our customizable solutions from a team member today.

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Fraud Medicaid Medicaid Licensing 52

MedTrainer

AUGUST 2, 2023

Federal Government Audits These audits are performed by government agencies such as the Centers for Medicare and Medicaid Services (CMS). They aim to ensure compliance with federal healthcare programs like Medicare and Medicaid, reviewing claims, billing practices, and overall adherence to program requirements.

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Compliance ACA Medicaid Medicaid 52

MedTrainer

JUNE 29, 2023

Individuals or entities found in violation of Stark Law may face exclusion from participation in federal healthcare programs such as Medicare and Medicaid. Organizations that violate Stark Law may also face the loss of Medicare and Medicaid reimbursements. Professional Reputational Damage.

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Compliance Compliance Officers Medicaid Medicaid 52

Compliancy Group

JULY 18, 2024

Understanding the OIG Compliance Program Guidance The purpose of the OIG in medical billing is to give companies guidance for their billing operations while helping them mitigate risks when submitting claims to entities such as Medicare. Schedule a demo to learn how to implement and maintain OIG compliance efforts today.

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Medical Billing Compliance Fraud Compliance Officers 52

MedTrainer

JANUARY 13, 2025

This includes all credential types: license to practice, board certification, work history, malpractice history, state licensing sanctions, and both Medicare/Medicaid sanctions and exclusions. Request a demo. Changes to credentialing application. The application attestation timeframe has been shortened considerably.

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Licensing Malpractice Medicaid Medicaid 52

MedTrainer

MAY 6, 2024

Schedule your demo to see MedTrainer Credentialing Software in action. Easily assign multiple enrollments to staff, update statuses, and prioritize. Download our guide – Tools to Conquer Provider Enrollment – for valuable tips on speeding up the time from credentialing to enrollment approval.

Licensing 52

Licensing Malpractice Health Insurance Medicaid 52

YouCompli

NOVEMBER 9, 2022

The OIG concluded the practice complied with Medicare billing requirements for 36 critical care services but did not comply for the remaining 56. There were two primary reasons for not meeting the Medicare billing requirements. schedule a demo. ?. Read more about? the rollout and accountability of requirements ?or?

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Compliance Medicare Medicare Hospitals 52

MedTrainer

JUNE 29, 2023

Schedule a demo today and get the peace of mind that comes from standardizing and optimizing your approach to compliance management. Today, compliance reporting software typically also plays a significant role in automating and streamlining processes related to data collection, analysis, documentation, and reporting.

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Compliance FDA Health Insurance Medicaid 52

MedTrainer

JULY 12, 2023

Organizations like The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), Food and Drug Administration (FDA), and Occupational Safety and Health Administration (OSHA) require incident reporting and response documentation as part of regulatory compliance. Regulatory Compliance. appeared first on Medtrainer.

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Compliance Regulatory Compliance FDA Medicaid 52

MedTrainer

JULY 12, 2023

Organizations like The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), Food and Drug Administration (FDA), and Occupational Safety and Health Administration (OSHA) require incident reporting and response documentation as part of regulatory compliance. Regulatory Compliance. appeared first on Medtrainer.

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Compliance Regulatory Compliance FDA Medicaid 52

YouCompli

JANUARY 4, 2022

Where does telehealth fit into our model if Medicare is reimbursing only 50 percent or less for the telehealth visit?”. Request a demo of the YouCompli solution. “I’m glad we can keep audio only telehealth, so we don’t exacerbate equity and access issues,” she said. Find out more about YouCompli.

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Compliance Licensing Hospitals Public Health 40

MedTrainer

APRIL 29, 2024

These include SAM, OIG, Medicare Opt-Out, NPDB and more, ensuring you can quickly and accurately identify excluded parties. Request a demo or visit our website to learn more or see MedTrainer in action. Provider Enrollments: MedTrainer’s proven workflow helps to keep your revenue intact with checklists, dashboards, and integrations.

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Compliance Licensing Hospitals Medicare 52

MedTrainer

AUGUST 25, 2023

For healthcare facilities that are accredited and contracted with federally-funded programs, such as Medicare and Medicaid, compliance with CMS regulations becomes paramount. Take a closer look at MedTrainer and everything it has to offer — schedule a free demo today.

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Compliance ADA HIPAA Medicaid 52

MedTrainer

AUGUST 2, 2023

Insurance Reimbursement Insurance companies — along with government programs like Medicare and Medicaid — require providers to be credentialed to ensure they meet specific standards and qualifications. Schedule a free demo today to see for yourself how easy Medtrainer makes credentialing — and how easy it is to reap the benefits.

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

YouCompli

JANUARY 4, 2022

Unger reported that her unit is focused on about 65% Medicare fraud and about 35% abuse and neglect. When people defraud the system they don’t just defraud Medicaid, they also get Medicare and private insurance. Request a demo of the YouCompli solution. Current mix of investigations. Find out more about YouCompli.

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Fraud Compliance Elder Abuse Medicaid 40