American Medical Compliance

JUNE 21, 2024

Fraud, waste, and abuse (FWA) in healthcare present significant challenges, causing substantial financial losses, eroding public trust, and compromising the quality of patient care. Unlike fraud, waste is not necessarily intentional but results from inefficiencies.

Fraud 105

Fraud Compliance Medicaid Medicaid 105

Medisys Compliance

SEPTEMBER 9, 2022

Optometry billing coders can accomplish this by acquiring the most recent coding books and by going to seminars to review their coding techniques. This frequent mistake might increase the likelihood that claims will be rejected, which could result in payment delays as well as a negative reputation in the sector or perhaps a fraud probe. .

Medical Billing 98

Medical Billing Medical Billing Outsourcing Doctors Fraud 98

American Medical Compliance

FEBRUARY 9, 2024

Compliance officers organize training sessions, workshops, and seminars to keep the workforce up to date. Monitoring and Auditing Compliance officers regularly monitor the organization’s operations to identify potential compliance issues.

Compliance Officers 102

Compliance Officers Compliance Patient Advocacy Regulatory Compliance 102

Physician Credentialing Company

JANUARY 6, 2025

Such upcoding activity can be considered fraud, and providers may have to bear legal proceedings. Hiring expert billers for in-house billing , regular audits, and motivating providers to attend educational seminars can be useful for smooth billing. Providers need to remain compliant with billing regulations.

Medical Billing 40

Medical Billing Medicare Medicare Compliance 40

AIHC

MARCH 2, 2023

My task was to educate providers and staff through seminars on rules and regulations with Medicare. Opposed to leading by providing seminars, motivating various clinical staff meant getting to know them and their capabilities and being able to let go. I needed to allow them to do their job and resist the reflex of micro-managing.

Compliance Officers 52

Compliance Officers Compliance Fraud Medical Billing 52

AIHC

AUGUST 30, 2023

Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM Due to the high volume of fraud schemes involving telemarketing revealed by the Department of Justice (DOJ) over recent years, it is important that providers heed “buyer beware” when engaging with a telemarketing firm. “If If it is too good to be true it probably isn't.”

Compliance 52

Compliance Fraud Medicare Medicare 52

Drug & Device Law

FEBRUARY 22, 2022

Plaintiff brought four fraud-based claims – common law fraud, constructive fraud, negligent misrepresentation, and violation of Pennsylvania’s consumer protection act. The learned intermediary doctrine bars this form of statutory fraud. But there are several other obstacles to common law fraud.

Fraud 59

Fraud Hospitals 59