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Understanding Sanction Screening: Safeguarding Healthcare Integrity Under HIPAA

Total Medical ComplianceHIPAA

HIPAA stands as a beacon of privacy and security standards within the industry. 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.

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How To Prepare for an OIG Inspection

MedTrainer

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. Medicare/Medicaid Compliance Reviews. The OIG performs regular compliance reviews of Medicare and Medicaid providers.

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Can Your Hospital Afford Not to Outsource Credentialing?

Verisys

Checks credentialing for Health Insurance Portability and Accountability Act (HIPAA) compliance. It’s also a requirement of federal payers like Medicare, Medicaid, and private insurance companies. In addition, there can be other indirect costs, such as rising malpractice insurance costs and associated fiscal penalties.

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Introduction to Telebehavioral Health

AIHC

Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs. This is also called “store-and-forward telemedicine.”

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Audio-Video Telehealth, Mobile Device Management & You

AIHC

Written by: Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, COCAS, CORCM, OHCC, ICDCT-CM/PCS This article addresses how to track telehealth policies while addressing HIPAA compliance and mobile device management as the United States enters into a post-pandemic era. What Additional Information Should I Know for Compliance?

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How to File a Complaint Against a Doctor in Florida

Florida Health Care Law Firm

Department of Health and Human Services, Statewide Medicaid Managed Care, Florida Department of Agriculture and Consumer Services, or another agency to continue to process your complaint. If you would like to file a complaint based on a HIPAA violation, you will have to file with the U.S. Department of Health and Human Services.

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What Is Provider Credentialing?

MedTrainer

It involves collecting and reviewing information such as education, training, licensure, certifications, work history, malpractice history, and references — all in pursuit of verifying that providers are who they say they are and qualified to deliver legitimate, safe, and ethical care.