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.

Compliance 52

Compliance Hospitals Fraud Regulatory Compliance 52

Verisys

DECEMBER 22, 2021

Passed last December, the Act requires group health plans and health insurance issuers to improve the verification and refresh process of their provider directory systems. Should a group health plan, insurer, or state agency find that time is running out on achieving regulatory compliance with H.R.

Compliance 52

Compliance Regulatory Compliance Health Insurance Healthcare information Technology 52

HIT Consultant

APRIL 16, 2024

Eric Demers, CEO Madaket Health In 2022, the Centers for Medicare & Medicaid Services (CMS) proposed the creation of a centralized physician directory. Recent research found that physician information held within directories of five major national health insurers was inconsistent in four out of five entries.

Regulatory Compliance 52

Regulatory Compliance Compliance Health Insurance Medicaid 52

MedTrainer

NOVEMBER 2, 2023

Additionally, hands-on experience in healthcare or regulatory compliance provides a foundation for this role. Many pursue certifications, like the Certified in Healthcare Compliance (CHC) , to gain a competitive edge and deepen their expertise.

Compliance Officers 52

Compliance Officers Compliance HIPAA Regulatory Compliance 52

MedTrainer

FEBRUARY 1, 2024

Corporate compliance can help to reduce these potential costs by helping companies uphold compliance standards. Meet Government Requirements: Some government programs and payers, such as the Centers for Medicare & Medicaid Services (CMS) , require healthcare facilities to have compliance programs as a condition for participation.

Compliance 52

Compliance Fraud Regulatory Compliance Regulations Compliance 52

Medisys Compliance

APRIL 25, 2023

Need of Choosing Oncology Billing Company As an oncology practice, selecting the right billing company is a crucial decision that can significantly impact your financial success and regulatory compliance. This article will discuss key factors in choosing oncology billing company.

Regulatory Compliance 52

Regulatory Compliance ACA Medical Billing Outsourcing Compliance 52

Verisys

FEBRUARY 14, 2024

This includes clinical risks, financial risks, cybersecurity threats, and compliance risks with laws and regulations such as HIPAA (Health Insurance Portability and Accountability Act) in the United States. For instance, within the realm of healthcare compliance, HIPAA compliance plays a pivotal role.

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

MedTrainer

MARCH 28, 2024

Law by law, regulations were added, increasing the complexity of maintaining compliance for healthcare organizations. Advises on compliance matters, reviews contracts, and handles regulatory and legal issues. Pros: Legal and regulatory compliance expertise, familiarity with laws and regulations, and trusted legal adviser.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

AIHC

MAY 30, 2024

These technologies have become a core function in RCM Operations and have also been adopted by the Health Insurance, Health System, and Provider communities across the United States. Compliance and Risk Management : Fraud Detection : AI systems can identify unusual patterns that may indicate fraudulent activities.

Compliance 52

Compliance HIPAA Regulatory Compliance Medical Billing 52

Health Care Law Brief

NOVEMBER 9, 2021

The Part II Rule generally expands the scope of claims eligible for external review as established under the Affordable Care Act to include adverse benefit determinations by health benefit plans and health insurance issuers related to compliance with the No Surprises Act. 2] See 86 Fed.

Medical Billing 75

Medical Billing Due Diligence Compliance Patient Satisfaction 75

Health Care Law Brief

FEBRUARY 6, 2023

The bill states that “physician practices are subject to far less oversight than [other facilities]” but that they “remain unregulated by the state outside of the licensure of the individual practitioners who practice at these sites and Medicaid enrollment.” at PHL § 4551(2).

Patient Satisfaction 52

Patient Satisfaction Licensing Health Insurance Medicaid 52

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.

Compliance Framework 52

Compliance Framework Governance Compliance Medicaid 52