Medisys Compliance

MARCH 31, 2025

Introduction For many physician practices, Medicare beneficiaries represent a significant portion of their patient population. However, navigating the complexities of Medicare billing can be a challenging task, especially when considering its distinct differences from private insurance models.

Medicare 59

Medicare Medicare Medical Billing Medical Billing Outsourcing 59

Medisys Compliance

MARCH 9, 2025

Understanding Medicare coverage for counseling can feel particularly challenging, but it is crucial. Many providers find themselves asking: What exactly does Medicare cover when it comes to outpatient mental health counseling services? This cornerstone of outpatient mental health care is generally well-covered by Medicare.

Medicare 59

Medicare Medicare Medical Billing Medical Billing Services 59

Bill of Health

OCTOBER 17, 2024

SB 1223 amended the California Consumer Privacy Act of 2018 to include neural data as sensitive personal information, whose collection and use companies can be directed to limit. In SB 1223, an amendment to the California Consumer Privacy (CCP) Act, California has protected neural data as sensitive personal information.

Medicare 150

Medicare Medicare Health Insurance Licensing 150

MRO Compliance

FEBRUARY 3, 2025

HEDIS (Healthcare Effectiveness Data and Information Set) is a critical quality measurement tool used to assess healthcare performance across various domains. Reminder of the audit process: According to NCQA , the HEDIS compliance audit contains two parts information system capabilities and HEDIS specification standards.

Patient Satisfaction 147

Patient Satisfaction Compliance Medicare Medicare 147

Healthcare Dive

OCTOBER 31, 2023

Regulators on Monday proposed a long-awaited rule tying payments for hospitals and doctor’s offices in three popular Medicare programs to compliance with data-sharing regulations.

Doctors 184

Doctors Medicare Medicare Compliance 184

Healthcare IT Today

NOVEMBER 26, 2024

The following is a guest article by Andrew Mignatti, Co-Founder and CEO at careviso As Medicare annual open enrollment is underway, healthcare providers soon face the overwhelming task of verifying benefits for millions of patients. This level of detail allows for more informed decision-making and helps prevent unexpected bills for patients.

Medicare 54

Medicare Medicare Patient Satisfaction Hospitals 54

Verisys

APRIL 8, 2025

T his information provides organizations with detailed reports for making well-informed hiring decisions. At a minimum, FACIS Level 1M satisfies the requirements of the OIG and CMS (Centers for Medicare & Medicaid Services) by screening providers for exclusions, debarments, disciplinary actions , and related issues.

Fraud 52

Fraud Medicaid Medicaid Compliance 52

Healthcare It News

SEPTEMBER 16, 2024

There's help for providers who want to help aging patients navigate complex government websites and access the information and resources they need to overcome isolation, lack of transportation and limited financial resources barring full access to healthcare opportunities. This raises a critical concern.

Medicare 301

Medicare Medicare Public Health Health Analytics 301

Medisys Compliance

FEBRUARY 19, 2025

Billing Update: Medicare Radiology Reimbursement Cuts 2025 Effective January 2025, radiology practices nationwide are facing reduced Medicare reimbursements due to finalized changes in the Physician Fee Schedule. Now, in February 2025, these proposed rules are our current reality. Here are key steps you can take: 1.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

Fierce Healthcare

JANUARY 25, 2024

The Centers for Medicare & Medicaid Services is seeking feedback on how to increase transparency around Medicare Advantage and improve data capabilities. |

Medicare 131

Medicare Medicare Medicaid Medicaid 131

Healthcare It News

APRIL 5, 2024

Diabetes WA discloses data breach Diabetes WA, the peak body for diabetes in Western Australia, has reported unauthorised access to the personal information of some of their contacts. The organisation already reached out to the affected individuals and recommended they apply for a replacement Medicare number.

COVID-19 310

COVID-19 Medicare Medicare Hospitals 310

HIT Consultant

OCTOBER 22, 2024

Making HPH-CPGs a Condition of Participation (CoP) for CMS : The Centers for Medicare & Medicaid Services (CMS) could require adherence to HPH-CPGs as a condition for participating in Medicare and Medicaid programs. He has been dedicated to the healthcare information technology and information management industry for over 30 years.

HIPAA 139

HIPAA Compliance Public Health Medicaid 139

Becker's Health IT

APRIL 8, 2024

Hacking group claims to have stolen 4TB of data, including information on insurers like CVS Caremark and Medicare, in cyberattack on Change Healthcare.

Medicare 128

Medicare Medicare 128

Healthcare IT Today

DECEMBER 22, 2024

Because theres so much happening out there in healthcare IT we arent able to cover in our full articles, we still want to make sure youre informed of all the latest news, announcements, and stories happening to help you better do your job. That said, rejection rates hit a trough in 2018 and have increased 16% since then.

Medicare 84

Medicare Medicare FDA Telemedicine 84

HIT Consultant

DECEMBER 3, 2024

AI will help analyze patient records (when available), personal demographic information, and vast amounts of treatment history to predict outcomes and recommend care pathways that will lead to better clinical outcomes. AI can automate the gathering of information. Guide personalized care plans. Automating talk therapy.

FDA 111

FDA Medicare Medicare Medicaid 111

Hall Render

FEBRUARY 17, 2025

According to a statement released on the Center for Medicare and Medicaid Services (CMS) website, effective February 14, 2025, implementation of the Hospice Special Focus Program for calendar year 2025 has ceased so that CMS may further evaluate the program. Hall Render blog posts and articles are intended for informational purposes only.

Medicare 89

Medicare Medicare Nursing Homes Medicaid 89

Healthcare IT Today

APRIL 19, 2024

Collecting social determinants of health (SDOH) information from patients is challenging. QliqSOFT is making it easier to get this important information while maintaining dignity. We wanted to find out more about how the company is helping healthcare organization collect SDOH information.

Doctors 120

Doctors HIPAA Nurses Medicare 120

HIT Consultant

JANUARY 19, 2025

For Medicare Advantage Organizations (MAOs), the summer months have historically been defined by the high stakes, tight turnarounds and document management challenges of the Annual Enrollment Period (AEP). This information is often stored and managed in various locations in different formats.

Medicare 52

Medicare Medicare Due Diligence Regulatory Compliance 52

Healthcare It News

JUNE 5, 2024

Healthcare companies and providers can now store HIPAA-protected data in the HubSpot customer relationship management platform to automate workflows, connect teams with closed-loop reporting and create campaigns with personalized information, the company said Tuesday. The nexus of technology and HIPAA compliance has evolved, however.

HIPAA 319

HIPAA Compliance Medicare Medicare 319

Healthcare IT Today

JANUARY 23, 2025

Shah, Co-Founder and CEO at Dina Payers Lean on Technology to Coordinate New Innovative Supplemental Benefits to Improve Quality, Outcomes, and Costs for Seniors Non-medical supplemental benefits like in-home support services, meal delivery, home modifications, and transportation have skyrocketed with Medicare Advantage (MA) plans.

Medicare 92

Medicare Medicare Medicaid Medicaid 92

MRO Compliance

NOVEMBER 21, 2024

The Centers for Medicare & Medicaid Services (CMS) 2025 Physician Fee Schedule (PFS) Final Rule brings notable updates to the Quality Payment Program (QPP), which will impact eligible clinicians, groups, virtual groups, subgroups, and APM entities.

Compliance 147

Compliance Medicare Medicare Medicaid 147

Hall Render

JANUARY 29, 2025

The Centers for Medicare & Medicaid Services (CMS) is reinforcing its emphasis on hospice quality of care and identifying fraud. Hospice surveys are performed before their initial certification for Medicare participation. Identifying Fraud : Detecting practices that jeopardize patient safety or Medicare program integrity.

Fraud 80

Fraud Medicare Medicare Compliance 80

Medisys Compliance

DECEMBER 19, 2024

From managing CPT codes for procedures like nail debridement and wound care to ensuring compliance with Medicares podiatry-specific guidelines, the billing process can be confusing. Diabetic Foot Care Billing: Medicare covers diabetic foot exams and therapeutic shoe fittings under specific conditions.

Medical Billing Outsourcing 105

Medical Billing Outsourcing Medicare Medicare Compliance 105

Healthcare It News

SEPTEMBER 9, 2022

The Centers for Medicare and Medicaid Services is inviting patients and their families, providers, clinicians, consumer advocates, healthcare professional associations, individuals serving underserved communities and all CMS stakeholders serving populations facing disparities in health and healthcare to submit public comments by November 4.

COVID-19 287

COVID-19 Medicaid Medicaid Public Health 287

AIHC

NOVEMBER 12, 2024

Written by Gabriella Neff, RHIA, CHA, CHC, CHRC, CHPC This past year, in 2024, revisions were made to clarify hospital guidelines related to informed consent specifically addressing UIEs (unconsented intimate exams) to patients while under anesthesia. OCR recently issued an FAQ focusing on this right. [6]

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Informed Consent HIPAA Compliance Hospitals 98

Healthcare It News

AUGUST 25, 2022

The company found that machine learning was able to accurately predict healthcare providers with at-risk patients due to loss of insurance coverage, including Medicare coverage gaps. Based on the predictive algorithm, the program sends the healthcare providers targeted financial resources information to share with the at-risk patients.

Health Outcomes 310

Health Outcomes Doctors Medicare Medicare 310

Healthcare It News

OCTOBER 31, 2022

The pilot, funded under a cooperative agreement by the Office of the National Coordinator for Health IT (ONC) and Health Level Seven International (HL7), focuses on applying FHIR Gravity social risk terminology – to exchange information.

Licensing 340

Licensing Medicaid Medicaid Health Outcomes 340

Healthcare It News

MAY 25, 2022

While other technologies are reactive to commands, ElliQ proactively suggests activities and initiates conversations, building context through artificial intelligence to inform follow-up conversations that create a sense of relationship with the AI, the company explained. billion in additional associated Medicare spending per year.

COVID-19 333

COVID-19 Medicare Medicare 333

Healthcare IT Today

NOVEMBER 13, 2024

Clinical Integration Analyst – North Memorial Health BI Developer – Phelps Health Director of Information Technology & Project Management – Pueblo Community Health Center, Inc.

Due Diligence 117

Due Diligence Medicare Medicare Hospitals 117

HIT Consultant

OCTOBER 22, 2024

What You Should Know: – Essence Healthcare , a provider of Medicare Advantage (MA) plans forms a new partnership with ŌURA , the maker of the Oura Ring. The Oura Ring t racks key health metrics such as: Sleep Patterns: Provides detailed information on sleep stages, duration, and quality. ”

Medicare 98

Medicare Medicare 98

Healthcare It News

OCTOBER 13, 2022

The Centers for Medicare and Medicaid Services Office of the National Coordinator for Health Information Technology final rule prevents information blocking and promotes competition and innovation in healthcare IT. Data tools are also high on the list of provider IT needs for FHIR adoption.

COVID-19 319

COVID-19 Medicaid Medicaid Medicare 319

Healthcare IT Today

MARCH 5, 2025

Here’s a quick look at some of the health IT jobs we found: Healthcare Cyber Security Principal – RSM US LLP Associate Chief Medical Informatics Officer-Inpatient – Baptist Memorial Health Care Director of Clinic Operations – McLaren Health Care IT Manager, Technical Services (IAM) – HMSA Health Information Analyst (Full (..)

Due Diligence 107

Due Diligence Medicare Medicare Hospitals 107

Healthcare It News

SEPTEMBER 27, 2024

She insisted that My Health Record must capture more patient information and make it easier for GPs to search them, as well as ensure data interoperability and timely notification when patient records are updated. The dashboard is also informed by the updated Australian consensus on treating moderate to severe psoriasis.

Nurses 297

Nurses Governance Public Health Medicare 297

HIT Consultant

APRIL 9, 2025

What You Should Know: – Health insurance members, both in commercial and Medicare Advantage plans, are increasingly relying on their health plan’s websites and mobile apps for communication. Medicare Advantage plans: Average app satisfaction is 597. – The J.D. Power 2025 U.S. ”

Health Insurance 52

Health Insurance Medicare Medicare 52

HIT Consultant

APRIL 18, 2025

– Synthesizing findings from three in-depth evaluations of digital health tools by the Peterson Health Technology Institute (PHTI) and analyzing trends in Medicare and Medicaid billing, the report sounds a timely alarm. However, the report reveals a concerning surge in Medicare billing for these services. million in 2023.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare It News

JANUARY 7, 2022

Getting that view requires gathering fragmented information held by outside providers, payers and the patients themselves. "Access to all of that data was contributing to information overload and confusion among consumers and, all too often, driving fragmented and wasteful care." THE PROBLEM. " Dr. Imran A.

COVID-19 363

COVID-19 Medicare Medicare Hospitals 363

Medisys Compliance

JANUARY 23, 2025

As we step into 2025, mental health providers must stay informed about evolving telehealth billing regulations to ensure compliance and optimize reimbursement. Will Medicare Stop Paying for Telehealth in 2025? Will Medicare Stop Paying for Telehealth in 2025? What Is the CPT Code for Telehealth in 2025?

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicare Medicare Medical Billing 59