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. Rightly so, as the transition from paper to digital records must be done strategically to ensure compliance with security and regulatory standards.

Records Management 124

Records Management Regulatory Compliance Compliance HIPAA 124

Medisys Compliance

MARCH 31, 2025

Accurate and efficient Medicare billing is not merely about receiving timely payments; it forms the base for financial stability, regulatory compliance, and ultimately, the ability to continue providing quality patient care. Modifiers play a crucial role in providing additional information about the services rendered.

Medicare 59

Medicare Medicare Medical Billing Medical Billing Outsourcing 59

HIT Consultant

JANUARY 12, 2025

AI-generated identity fraud, including deepfakes, and other sophisticated tactics are making traditional security systems obsolete. In retail, e-commerce platforms deploy facial recognition alongside behavioral biometrics to reduce fraud during online purchases, providing a seamless yet secure shopping experience.

Fraud 64

Fraud Regulatory Compliance Ransomware Compliance 64

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

Total Medical Compliance Resources

NOVEMBER 11, 2024

Cybersecurity is just one aspect of the broader information security landscape, with physical security being another crucial component that can sometimes be neglected. link] Secure Storage of Protected Health Information (PHI) Course $15.00 link] HIPAA Fraud, Waste, and Abuse Awareness Course $30.00

ADA 59

ADA HIPAA Compliance Fraud 59

MedTrainer

MAY 12, 2021

The Hidden Benefits of Regulatory Compliance in Healthcare. With its maddening complexities and time- and resource-consuming demands, regulatory compliance is thought to be the plague of any thriving business. But what is compliance in healthcare? Fact: Regulatory Compliance in Healthcare is an Advantage.

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Regulatory Compliance Compliance HIPAA Medical Personnel 40

Verisys

DECEMBER 29, 2024

Healthcare organizations and insurance companies rely on credentialing to ensure patient safety, regulatory compliance, and minimize liability risks. This includes verifying education, residency, employment history, malpractice insurance, hospital privileges, and board certifications. appeared first on Verisys.

Malpractice 52

Malpractice Licensing Regulatory Compliance Hospitals 52

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. These laws outline procedures that prevent the inappropriate use of federal funds, protect sensitive patient information, and ensure safe working conditions for all personnel.

Compliance 97

Compliance Fraud Regulatory Compliance HIPAA 97

Healthcare IT Today

MARCH 27, 2025

With only 6% of organizations having fully operationalized responsible AI frameworks , the healthcare industry must take a measured approach to ensure AI integration aligns with patient safety and regulatory compliance.

Governance 60

Governance Compliance HIPAA Regulatory Compliance 60

MedTrainer

JANUARY 21, 2025

Understanding the OIG Exclusion List The OIG maintains the List of Excluded Individuals/Entities (LEIE), which provides comprehensive information to the healthcare industry on those currently excluded from participating in Medicare, Medicaid, and any other federal healthcare programs.

Compliance 52

Compliance Fraud Regulatory Compliance Medicare 52

Health Care Law Brief

JULY 21, 2022

On July 20, 2022, the Office of Inspector General for the Department of Health and Human Services (“ OIG ”) issued a special fraud alert (“ Alert ”) advising “practitioners to exercise caution when entering into arrangements with purported telemedicine companies.” OIG Flags Seven Characteristics of Telehealth Fraud.

Fraud 52

Fraud Telemedicine COVID-19 Governance 52

Healthcare IT Today

DECEMBER 26, 2024

Recent incidents involving fake video calls and voice cloning demonstrate the technology’s potential for sophisticated fraud. Patient-centric access controls enabling granular data privacy protections will also be key to maintaining trust and regulatory compliance.

US Department of Health and Human Services 90

US Department of Health and Human Services Ransomware Compliance Hospitals 90

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. Organizations use this official data to: Make informed hiring and credentialing decisions.

Malpractice 52

Malpractice Licensing Compliance Hospitals 52

HIT Consultant

JULY 25, 2024

However, according to Astra, some of the most commonly suggested are: HITRUST CSF – a gold standard in data security for organizations dealing with protected health information (PHI), the HITRUST Framework is a comprehensive, scalable, reliable, and efficient framework for risk management and regulatory compliance.

Compliance 111

Compliance HIPAA Regulatory Compliance Ransomware 111

HIT Consultant

MAY 4, 2023

Don Kelly, Manager of the Virtual Information Security Program at Fortified Health Security It’s a fact: More than 80% of data breaches involve a human in some way. The “grooming” process can take weeks, underscoring the lengths hackers will go to steal information.

Hospitals 97

Hospitals HIPAA Regulatory Compliance Compliance 97

American Medical Compliance

FEBRUARY 9, 2024

Compliance ensures that patient information is kept confidential, billing is accurate, and quality of care remains top-notch. The Role of Compliance Officers Compliance officers are the linchpin in the complex machinery of healthcare organizations.

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Compliance Officers Compliance Patient Advocacy Regulatory Compliance 102

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. Today, the cost of a data breach comes with a hefty price tag – an average of $9.44 million in the U.S.

Regulatory Compliance 52

Regulatory Compliance Due Diligence Compliance Compliance Framework 52

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.

Compliance 52

Compliance Regulatory Compliance Fraud Regulations Compliance 52

HIT Consultant

APRIL 10, 2025

Since healthcare organizations frequently deal with confidential patient information, financial transactions, and regulatory compliance, these attacks pose a significant risk to the industry. These stealthy malware programs operate undetected, harvesting data from infected systems and transmitting it back to attackers.

Regulatory Compliance 52

Regulatory Compliance Ransomware Fraud Compliance 52

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.

Compliance 52

Compliance Compliance Officers Fraud Regulatory Compliance 52

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.

Compliance 52

Compliance Hospitals Fraud Regulatory Compliance 52

MedTrainer

JULY 29, 2024

These tools make it easier for healthcare organizations to maintain a culture of compliance, adapt to evolving industry standards, and ensure that all staff members are consistently informed and compliant. Corporate Compliance vs. Regulatory Compliance Corporate compliance and regulatory compliance are not the same thing.

Compliance 52

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

Health Law RX

JANUARY 30, 2024

By maintaining a robust compliance program, healthcare companies are better able to identify potential red flags early and to prevent violations of fraud and abuse laws. The GCPG further explains how to implement these elements.

Compliance 52

Compliance Due Diligence Fraud Governance 52

Verisys

FEBRUARY 6, 2025

Provider data management in healthcare is the systematic process of collecting, organizing, and maintaining accurate information about healthcare providers. It’s all about keeping provider information current and accessible, helping healthcare systems run more efficiently and deliver better care. The key components include.

Regulatory Compliance 52

Regulatory Compliance Compliance Licensing Malpractice 52

Total Medical ComplianceHIPAA

JANUARY 11, 2024

These screenings search through various databases containing records of individuals or organizations barred from participating in Medicaid, Medicare, or other federal/state healthcare programs due to fraud, abuse, or other offenses. Why is Sanction Screening Vital Under HIPAA?

HIPAA 52

HIPAA Malpractice Regulatory Compliance Compliance 52

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. and cybersecurity threats.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

Compliancy Group

OCTOBER 4, 2024

Despite your best efforts in meeting healthcare compliance requirements, errors may still occur. Maintaining the security and integrity of sensitive information and preventing waste, fraud, and abuse is essential to quality healthcare and promoting workplace safety. We’ll explore the various types of healthcare audits.

Compliance Officers 59

Compliance Officers Compliance Regulatory Compliance Fraud 59

Verisys

JANUARY 8, 2024

A healthcare compliance audit is a thorough review and examination of an organization’s adherence to regulatory guidelines. This type of audit is essential in the healthcare industry for several reasons: Regulatory Compliance It ensures that the healthcare organization complies with various federal and state laws and regulations.

Compliance 52

Compliance Regulatory Compliance Health Insurance Medicaid 52

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. There are five additional benefits to explore that clarify the Plan’s powerful value. Does the OIG Work Plan Help Your Organization?

US Department of Health and Human Services 52

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

MedTrainer

JULY 25, 2024

This act safeguards patients’ protected health information (PHI) and health plans and defines security and privacy regulations regarding patient data. HIPAA, enacted in 1996, originally aimed to improve health insurance portability and reduce healthcare fraud. What Is HIPAA? physicians, clinics, hospitals), health plans (e.g.,

HIPAA 52

HIPAA Compliance Health Insurance Fraud 52

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.

Nurses 52

Nurses US Department of Health and Human Services Licensing Regulatory 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.

Compliance 52

Compliance Regulatory Compliance Governance Fraud 52

HIT Consultant

JANUARY 3, 2023

Department of Health and Human Services Office of Information Security noted in a 2022 report on health sector cybersecurity, that threat actors continue to evolve and become more sophisticated and effective in their attacks. The Challenges to Meeting Compliance Regulations.

Compliance 52

Compliance Ransomware Fraud Regulatory Compliance 52

Verisys

FEBRUARY 14, 2024

This holistic approach to governance ensures that decisions are informed by a comprehensive understanding of the hospital’s overall performance and its implications for patient care. It is crucial for ensuring patient safety, safeguarding privacy, and enhancing the quality of care through informed decision-making.

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

Medisys Compliance

JULY 8, 2024

NLP algorithms can extract relevant information from unstructured clinical data, facilitating precise coding. By providing an immutable record of all transactions, blockchain reduces the risk of fraud and enhances trust between providers and payers. Each transaction is securely recorded, ensuring data integrity and transparency.

Medical Billing 59

Medical Billing Patient Satisfaction Medical Billing Outsourcing Compliance 59

MedTrainer

JANUARY 31, 2024

It emphasizes understanding the privacy and security aspects of patient information in healthcare settings. 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.

Compliance 52

Compliance Compliance Officers Fraud HIPAA 52

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.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52