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.

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

Total Medical Compliance Resources

NOVEMBER 11, 2024

This course covers general procedures, handling verbal or physical threats, addressing profanity and abusive language, managing physically violent patients, post-incident documentation, breaking bad news to patients, and terminating a patient’s relationship with the practice. link] HIPAA Fraud, Waste, and Abuse Awareness Course $30.00

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Healthcare IT Today

DECEMBER 21, 2023

Predominantly, the risk of fraud, theft, or abuse of customer or company information increases, which can cause regulatory violations resulting in significant fines and penalties. Regulatory compliance, such as adherence to HIPAA, becomes even more critical in the digital landscape, where the risk of data exposure is heightened.

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Healthcare Blog

JANUARY 19, 2025

Compliance with Medicare Swing Bed Rules is non-negotiable for CAHs operating these programs. Provide a framework for proper documentation and billing practices. Prevent fraud and abuse of Medicare funds. Documentation Standards : Proper documentation is essential for both compliance and reimbursement.

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Compliancy Group

AUGUST 28, 2024

The Importance of HR Compliance Training Courses Compliance regulations in healthcare are designed to help organizations prevent fraud, waste, and abuse. All staff members working in healthcare settings, especially those who handle patients and EMRs, need to know how compliance regulations inform their day-to-day duties.

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MedTrainer

JANUARY 21, 2025

Mandatory exclusions result from serious convictions, including Medicare fraud, patient abuse, and felony healthcare fraud. The ability to quickly produce comprehensive screening records and demonstrate consistent monitoring practices provides proof of a strong compliance commitment.

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Compliancy Group

JULY 17, 2023

These services encompass comprehensive healthcare compliance programs and plans supported by cutting-edge technology solutions aimed at achieving optimal healthcare regulatory compliance. Close Healthcare Compliance Programs: The Important Aspects There are many important aspects when it comes to healthcare compliance programs.

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American Medical Compliance

FEBRUARY 9, 2024

Monitoring and Auditing Compliance officers regularly monitor the organization’s operations to identify potential compliance issues. Compliance officers maintain detailed records of compliance activities, investigations, and corrective actions.

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Compliancy Group

OCTOBER 16, 2024

Some compliance officers turn to free resources like the Department of Health and Human Services (HHS) risk assessment tool to assess their organizational compliance and risk, while others use spreadsheets or software. Risk management refers to identifying, avoiding, and mitigating the factors contributing to healthcare non-compliance.

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Compliancy Group

OCTOBER 4, 2024

Maintaining the security and integrity of sensitive information and preventing waste, fraud, and abuse is essential to quality healthcare and promoting workplace safety. We also discuss how compliance software can help ensure regulatory compliance and maximize efficiency and accuracy in all your compliance activities.

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Compliance Officers Compliance Regulatory Compliance Fraud 59

Compliancy Group

JANUARY 22, 2024

Critical Components of a Healthcare Compliance Audit Checklist There are several necessary components in a comprehensive healthcare compliance audit checklist that help maintain adherence to regulatory standards. Documentation Review The first step in any healthcare audit is thoroughly reviewing all required documentation.

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HIT Consultant

FEBRUARY 9, 2023

A lack of regulatory compliance, network and technical vulnerabilities, unencrypted information, unsecured mobile devices, and weak credentials all play a part in putting a healthcare organization at risk for a data breach. Paul Banco, CEO of etherFAX    How secure is your data? How Can a Data Breach Be Prevented?

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Compliancy Group

MAY 15, 2024

The healthcare landscape is fraught with complexities, and staying compliant involves understanding the OIG’s specific targets for hospital audits and crafting your OIG compliance program for your hospital with those in mind. Customizable Compliance Plans: Tailor your compliance strategies to fit the unique needs of your hospital.

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MedTrainer

FEBRUARY 1, 2024

A corporate compliance program in healthcare is a comprehensive set of policies, procedures, and practices that healthcare organizations establish and maintain to ensure that they operate compliant with all applicable laws, regulations, and ethical standards. Why do healthcare facilities use corporate compliance programs?

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Verisys

DECEMBER 29, 2024

Healthcare organizations and insurance companies rely on credentialing to ensure patient safety, regulatory compliance, and minimize liability risks. Primary Source Verification Healthcare organizations contact educational institutions, licensing boards, and past employers to verify the accuracy of submitted documents.

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Compliancy Group

OCTOBER 17, 2023

With the healthcare industry constantly transforming and adapting, managing risks has become a critical aspect of ensuring patient safety, organizational resilience, and regulatory compliance. These strategies should be documented within the Enterprise risk management framework to ensure consistency in risk management practices.

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MedTrainer

JULY 25, 2024

Because enterprise healthcare organizations may employ hundreds or thousands of people, having a HIPAA compliance checklist helps to effectively manage the complexities of protecting patient information, reducing the risk of violations, and maintaining a culture of compliance throughout the organization. What Is HIPAA?

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Compliancy Group

APRIL 17, 2024

Office of Inspector General (OIG) in the Department of Health and Human Services (DHHS) oversees efforts in the healthcare sector to identify, reduce, and prevent incidents of fraud, waste, and abuse of funds from programs like Medicare. and cybersecurity threats. Review the OIG annual work plan for risk areas that can be improved in advance.

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MedTrainer

AUGUST 30, 2023

Some key compliance elements for managed care organizations include: Legal and Regulatory Compliance. These include laws related to insurance, healthcare privacy (HIPAA), billing practices, and fraud and abuse prevention. Risk management is a crucial aspect of healthcare compliance, including for MCOs.

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Compliance Regulatory Compliance Medicaid Medicaid 52

Compliancy Group

OCTOBER 2, 2023

This article will explore the significance of compliance reporting in healthcare and how it helps organizations maintain data integrity and mitigate risks. What is Compliance Reporting in Healthcare? This allows them to take corrective actions promptly and avoid penalties or legal repercussions arising from non-compliance.

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Compliancy Group

JANUARY 17, 2024

The OIG Work Plan, sometimes referred to as “the Work Plan” or “the Plan,” is an essential tool in securing and maintaining healthcare regulatory compliance for patient safety, privacy, and quality care. In this blog post, we look closely at the intricacies of the Plan, exploring how it shapes the healthcare compliance landscape.

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

Compliancy Group

AUGUST 2, 2023

This process involves conducting comprehensive risk assessments to: Identify Vulnerabilities Develop Risk Mitigation Plans Continuously Monitor Emerging Risks By proactively addressing potential issues, healthcare organizations can minimize financial losses, protect patient data and maintain regulatory compliance.

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Compliance Regulatory Compliance Governance Fraud 52

Compliancy Group

JANUARY 23, 2024

Understand Compliance Landscape Before you can write a comprehensive compliance plan, it’s crucial to grasp the intricacies of the healthcare compliance landscape. Protecting patients’ rights, ensuring privacy and data security, preventing fraud and abuse, and promoting fair billing practices. The primary goal?

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Compliance Regulatory Compliance Governance Fraud 52

MedTrainer

JANUARY 31, 2024

Certified Professional Compliance Officer (CPCO): The CPCO certification is offered by the American Academy of Professional Coders and is tailored to professionals who manage and lead compliance programs. Certified Medical Compliance Officer (CMCO): The CMCO certification is offered by the Practice Management Institute.

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Verisys

FEBRUARY 6, 2025

By thoroughly evaluating a nurse’s credentials, healthcare organizations can: Minimize the risk of medical errors Ensure compliance with regulatory requirements Maintain a high level of patient trust Credentialing also serves as a mechanism for ongoing professional development. It can also put patient safety at risk.

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Nurses US Department of Health and Human Services Licensing Regulatory Compliance 52

Healthcare IT Today

JUNE 29, 2023

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. ASCs must stay current on healthcare regulations that affect billing.

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MedTrainer

NOVEMBER 2, 2023

Most compliance officers possess a bachelor’s degree, often in healthcare administration, law, or a related field. Additionally, hands-on experience in healthcare or regulatory compliance provides a foundation for this role. Healthcare Risk Management Risk management identifies potential threats to compliance.

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Compliance Officers Compliance HIPAA Regulatory Compliance 52

Innovaare Compliance

JUNE 8, 2023

Your audit response plan should include: A process for identifying and responding to audit findings A process for tracking audit progress A process for communicating with CMS Inovaare knows the world of Medicare, Medicaid and Commercial health plans from over 125 years of combined hands-on Regulatory Compliance department oversight.

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Medicaid Medicaid Medicare Medicare 52

Physician Credentialing Company

JULY 15, 2024

This process reduces the risk of fraud and ensures accuracy. Steps of the Credentialing Process in Healthcare The credentialing process involves several steps including gathering documentation, verifying credentials, reviewing applications, and monitoring ongoing qualifications.

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MedTrainer

AUGUST 2, 2023

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. Typically, the credentialing process starts as soon as a physician applies to work.

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MedTrainer

JULY 31, 2024

A well-executed GRC strategy using healthcare compliance management software enables organizations to improve patient safety outcomes by proactively identifying and mitigating potential risks. This includes everything from document and policy management to incident reporting, compliance training, and credentialing.

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Healthcare IT Today

AUGUST 15, 2024

regulators sued for fraud, citing neglected cybersecurity and severe vulnerabilities. Develop contingency plans including well-documented manual workarounds and disaster recovery scenarios. So, what lies ahead? Look to SolarWinds. The fallout from their 2020 breach was catastrophic – as it will be for CrowdStrike – U.S.

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AIHC

MAY 30, 2024

Compliance and Risk Management : Fraud Detection : AI systems can identify unusual patterns that may indicate fraudulent activities. Regulatory Compliance : AI helps ensure billing and coding practices comply with current healthcare regulations. 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

Health Care Law Brief

FEBRUARY 7, 2022

It is unclear, however, whether this new regulatory framework will ultimately benefit requestors. at 1368 (emphasis added). However, OIG’s sentiment may presume too much. First, OIG appears to presuppose that any conduct under investigation by DOJ—by virtue of it being under investigation—is problematic. 1008.40 (emphasis added).

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Fraud Governance Compliance Regulatory Compliance 52

Florida Health Care Law Firm

MARCH 9, 2022

A pharmacist should evaluate each prescription, focus on regulatory compliance, and only dispense a prescription written for a legitimate medical purpose and pursuant to a valid prescriber-patient relationship.

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Regulatory Compliance Compliance Doctors Fraud 40

MedTrainer

NOVEMBER 15, 2023

In the United States, there are several compliance frameworks and entities that govern requirements for the healthcare industry. Each governing body oversees a different aspect of regulatory compliance. To understand which compliance frameworks govern which requirements, we need to break it down entity by entity.

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Drug & Device Law

DECEMBER 29, 2023

2023) ( Buckman preemption barred MDL asserting fraud on EPA), cert. Plaintiff knew about it, too, since he signed an informed consent document mentioning it. Negligence requires an evaluation of a defendant’s reasonableness, and all relevant NC authority includes relevant regulatory compliance in that mix. 4th 696 (3d.

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