Medisys Compliance

JANUARY 17, 2023

If you’ve ever questioned about outsourcing your medical billing, this article will go through all the benefits it offers you in terms of operations, and all the reasons to outsource medical billing. Now, let’s consider the factors to consider when outsourcing Behavioral Health medical billing: 1.

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Medical Billing Medical Billing Outsourcing Medical Billing Services Doctors 52

HIT Consultant

NOVEMBER 13, 2024

The company’s AI-powered platform tackles the estimated $300B fraud, waste, and abuse (FWA) crisis in healthcare, which often manifests as medical overbilling. Studies suggest that up to 80% of medical bills contain errors, leading to significant financial leakage for self-insured employers.

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Healthcare IT Today

JULY 30, 2024

GenAI can optimize administrative tasks like medical billing for precision and cost-effectiveness while predicting outcomes and automating billing, coding, and documentation. Efficient decision-making and enhanced patient care efficiency with real-time quality checks and improved overall revenue cycle management.

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Medisys Compliance

FEBRUARY 27, 2023

Challenges of Wound Care Billing Wound care billing can be a complex and challenging process due to several factors including, coding complexity, documentation requirements, reimbursement limitations, billing multiple payers, and risk of fraud & abuse billing.

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Medical Billing Medical Billing Outsourcing Patient Satisfaction Fraud 52

Medisys Compliance

JANUARY 30, 2023

The medical billing industry is a complex and ever-changing field, and it is crucial for healthcare providers and billing companies to stay compliant with government regulations. State Laws: In addition to federal laws, medical billing companies and healthcare providers must also comply with state laws and regulations.

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Compliancy Group

FEBRUARY 7, 2024

This is because the Centers for Medicare & Medicaid Services (CMS) have ramped up their efforts to identify organizations that have improperly billed for medical services. The Centers for Medicare and Medicaid Services (CMS) created UPIC audits to identify and stop fraud and abuse in Medicare and Medicaid.

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Medisys Compliance

OCTOBER 20, 2023

Emergency medical billing is a critical component of healthcare services, playing a pivotal role in ensuring that healthcare providers are adequately compensated for their life-saving efforts. Thorough Documentation: Comprehensive and accurate documentation is the cornerstone of proper coding and billing.

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Medical Billing Medical Billing Outsourcing Medical Billing Services Telemedicine 59

Medisys Compliance

NOVEMBER 23, 2023

Incomplete or Inconsistent Documentation Incomplete or inconsistent documentation can impede proper coding and lead to claim denials. Clear and concise procedure descriptions: Clearly document the type of radiology procedure performed, including the specific views, sequences, and any contrast materials used.

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Medical Billing Outsourcing Medical Billing Compliance Fraud 59

Medisys Compliance

JULY 13, 2022

Outsourcing your medical billing and coding operations to a revenue cycle company like Medisys Data Solutions can solve lot of staffing problems. To tackle this challenge healthcare financial leaders should shift their mindsets and think about medical billing vendors as their partners in growth.

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Medical Billing Medical Billing Outsourcing COVID-19 Fraud 52

Medisys Compliance

NOVEMBER 6, 2023

Introduction Orthopedic billing compliance is essential for healthcare providers to avoid costly audits and penalties. By following a comprehensive orthopedic billing compliance checklist, providers can ensure that their claims are accurate, complete, and supported by proper documentation.

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Medisys Compliance

OCTOBER 31, 2023

Medical billing and coding are critical components of the healthcare industry, ensuring that healthcare providers are reimbursed for their services accurately and efficiently. For those specializing in internal medicine, understanding the basics of internal medicine billing is essential.

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Medical Billing Outsourcing Medical Billing Compliance Medicaid 59

AIHC

MAY 31, 2022

health care system relies heavily on third-party payers to pay the majority of medical bills on behalf of patients. Health care insurance fraud is a pressing problem, causing substantial and increasing costs in medical insurance programs. First, remember that anyone can commit health care fraud.

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AIHC

SEPTEMBER 3, 2024

These guides were to be used as voluntary, nonbinding documents to support health care industry stakeholders with the intent that they be used for self-monitoring purposes. OIG intends to publish these guidance documents in 2024, but as of September 2024, we are still waiting for more ICPG information.

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Compliance Officers Compliance Fraud Medicare 52

Medisys Compliance

NOVEMBER 26, 2024

SNF billing compliance refers to the adherence to federal and state regulations governing billing processes for skilled nursing facilities. These regulations are designed to ensure accurate claims, prevent fraud, and promote proper reimbursement for services rendered to patients. What if SNF care is not medically reasonable?

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Compliance Medical Billing Outsourcing Medicare Medicare 52

Medisys Compliance

MARCH 7, 2022

These are usually just innocuous mistakes that do not represent any intent to commit billing fraud. signing off on your notes or if you’re trying to pad the record with billing elements. You want unique documentation for each encounter, and it should stand out in your progress note. But the payers don’t see it that way.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Overpayments Overpayment 52

Medisys Compliance

AUGUST 21, 2024

Overview of CMS Radiation Oncology Billing Guidelines The CMS radiation oncology billing guidelines establish the framework for how radiation oncology services should be billed to ensure proper reimbursement under Medicare and Medicaid. Providers must ensure that their billing practices are fully compliant to avoid penalties.

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Medical Billing Outsourcing Compliance Medicaid Medicaid 59

MedTrainer

JANUARY 26, 2024

Non-compliance in this area includes unauthorized access to patient records, inadequate data encryption, and improper disposal of medical records. Automated Reminders: Rely on automated alerts and notifications to complete training requirements, sign documents, and make policy updates.

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YouCompli

OCTOBER 17, 2023

Non-procedural services also have corresponding medical codes. For example, during a patient consultation, a physician might take a medical history from a patient, perform a physical exam, and then document their medical decision and disease management.

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AIHC

JUNE 6, 2023

Due to the complex nature of accurate coding, charge capture, billing and reimbursement, AI technology holds the potential to transform medical billing. This is certainly an area where advanced technology is needed to reduce overhead, improve compliance and reduce billing errors.

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Healthcare Law Blog

NOVEMBER 9, 2023

Thereafter, OIG said it planned to update existing industry-specific compliance program guidance (ICPG), which would include tailoring each to address fraud and abuse risk areas specific to a particular industry and describing the compliance measures that industry could take to reduce these risks [2].

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Medisys Compliance

APRIL 27, 2022

Another goal was to prevent healthcare fraud. Electronic data is on boom but we cannot ignore the importance of hard copies of the patient’s documents. The post Tips to Keep Your Practice HIPAA Compliant appeared first on Leading Medical Billing Outsourcing Services Company in the USA. Secured Hard Copies.

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Healthcare IT Today

JUNE 29, 2023

ASCs must stay current on healthcare regulations that affect billing. To avoid penalties, maximize revenue, and accurately document claims, ASCs must understand these changes. Understanding ASCs Regulatory Changes and Their Billing Practices Outpatient surgery centers (ASCs) perform many surgical procedures outside of hospitals.

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Physician Credentialing Company

JULY 15, 2024

For example, when a doctor claims to have graduated from a certain medical school, the credentialing team contacts that school directly to confirm. This process reduces the risk of fraud and ensures accuracy. They also ensure all documentation is complete and meets the necessary criteria before granting privileges to work.

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Medisys Compliance

APRIL 19, 2023

The enrollment process involves submitting an enrollment application, providing required documentation, and completing a provider agreement. Providers must also comply with Medicaid program integrity initiatives designed to prevent fraud, waste, and abuse.

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Medicaid Medicaid Medical Billing Outsourcing Licensing 52

AIHC

JUNE 6, 2023

Due to the complex nature of accurate coding, charge capture, billing and reimbursement, AI technology holds the potential to transform medical billing. This is certainly an area where advanced technology is needed to reduce overhead, improve compliance and reduce billing errors.

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Compliance Medical Billing HIPAA Due Diligence 52

MedTrainer

JULY 21, 2022

However, unauthorized access is causing more than just identity fraud. According to the US HSS, there have been around two breaches reported daily in 2021, and 723 breaches have been documented between March 2021 and February of the next year. Since 2020, approximately 113 million people have been impacted by healthcare data breaches.

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US Department of Health and Human Services HIPAA COVID-19 Compliance Officers 52

Healthcare IT Today

SEPTEMBER 19, 2023

A National Patient Identifier (NPI) would help get all patient documentation into one location vs. spread out among multiple providers and healthcare systems.

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MedTrainer

NOVEMBER 2, 2023

Their duties span across several areas, from ensuring adherence to laws to navigating the complexities of medical billing protocols. Compliance officers must understand these rules, ensuring organizations deliver quality care without fraud. What Is the Primary Role of a Compliance Officer in Healthcare?

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MedTrainer

FEBRUARY 13, 2022

During the credentialing procedure, a candidate’s documentation is sent back to the institution that first issued them, such as a university to confirm their legitimacy. For example, hospitals can outsource credentialing services to medical billing companies. It’s like a background check on steroids. .

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US Department of Health and Human Services Medical Billing Hospitals Compliance 40

MedTrainer

AUGUST 8, 2022

During the credentialing procedure, a candidate’s documentation is sent back to the institution that first issued them, such as a university to confirm their legitimacy. For example, hospitals can outsource credentialing services to medical billing companies. It’s like a background check on steroids. .

US Department of Health and Human Services 40

US Department of Health and Human Services Medical Billing Hospitals Compliance 40

AIHC

MAY 30, 2024

AI-Powered Challenges Historically, rule-based algorithms for coding and claim adjustments (also known as coding-related edits) were created to streamline the claims adjudication and payment procedure for providers sending medical bills to payers. Opportunity: One or more edits caused the entire claim to be rejected 1.2

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Compliance HIPAA Regulatory Compliance Medical Billing 52

Hall Render

JULY 26, 2024

This new NJ medical debt law may help you CrowdStrike software outage prompts cancellations at major NJ hospital network Gov. Murphy signs new medical debt protections into law Some N.J. Joseph Hospital opens new cardiology practice N.H.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses COVID-19 40

Hall Render

JULY 26, 2024

This new NJ medical debt law may help you CrowdStrike software outage prompts cancellations at major NJ hospital network Gov. Murphy signs new medical debt protections into law Some N.J. Joseph Hospital opens new cardiology practice N.H.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses COVID-19 40

Hall Render

MAY 10, 2024

Health Policy Commission still missing key document in Steward sale to Optum Local obesity drug developer lands deal worth up to $600M with Novo Nordisk Mass. Health Policy Commission still missing key document in Steward sale to Optum Local obesity drug developer lands deal worth up to $600M with Novo Nordisk Mass.

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Hall Render

JUNE 7, 2024

Newsweek lists best US maternity hospitals Tenet, HCA shareholders reject calls to report risks from providing abortion services Bexar County hospitals saw over 270,000 patients in 2022 Steward secures green light for 31 hospital sale dates Texas Medical Center through the years, from 1925 through present day How a wearable is optimizing patient monitoring (..)

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US Department of Health and Human Services Nurses Hospitals Nursing Homes 40

Hall Render

MAY 19, 2023

SOUTH CAROLINA Grand Strand hospitals hope to see positive impact from Certificate of Need repeal McMaster signs South Carolina’s certificate of need repeal Newly-passed bill allows MUSC to move forward with delayed Nexton Hospital build Prisma Health records $31.7M Employees love it. ProMedica taps Ascension St.

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Hall Render

JANUARY 14, 2022

documented COVID-19 cases, nears 25,000 deaths. Florida hospitals face severe staffing shortage ‘crisis’ Florida medical supply company to pay $600K in Medicare fraud settlement. Surgery Centers and Medical Offices in New Jersey Settle Allegations of Federal Health Care Fraud. Arizona surpasses 1.5M

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