The Centers for Medicare and Medicaid Services (CMS) has proposed major changes into the Conditions of Participation for Discharge Planning. These changes will have a profound effect on case management departments, which are now required to put in place a plan of action that addresses the new ... Views: 2424
A Claim Adjustment Reason Code (CARC) is a code used in medical billing to communicate a change or an adjustment in payment. CARCs have to be used to communicate why there was a difference between the amount paid in a claim or service line and the amount that was billed against it. CARCS are to ... Views: 2003
Summary: MentorHealth, a leading provider of online training for the healthcare industry, is organizing a webinar on October 3 on the topic, “Quality Assurance in Nursing”. It will be presented by Dev Raheja, faculty at Florida Tech University. ... Views: 1525
In this age of outsourcing and globalization, and with it, the emerging potential phenomenon of the Internet of Things (IoT); it is quite a tempting proposition for HIPAA Business Associates or Covered Entities to think of outsourcing their processes relating to Protected Health Information ... Views: 1085
Collections and Appeals for past due amounts can be difficult in any industry; adding the Medical Billing office element to it complicates it further. With this, one has the share of cost for patients, Medicare rules and Regulations, Private Payor contracts, and Collectors without experience in ... Views: 1057
The Electronic Health Record (EHR) license agreement is the core document for physician practices that have just entered the EHR arena, as well as for practices that transition to a new EHR software package.
The license agreement should ideally state and clear issues such as:
o Whether and ... Views: 954
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a US legislation that was enacted under the HITECH Act under Bill Clinton’s presidency with the intention of offering safeguards for medical information through its data privacy and security provisions. The Act consists ... Views: 945
Violations of ethical law by psychologists are a major topic for the society in general and the healthcare industry in particular because psychologists are a highly trained and skilled workforce in the medical profession. Since mental healthcare practitioners work in today's diverse, ... Views: 927
The costs of medical malpractice are exorbitant, to put it mildly. First, what is a medical malpractice? A straightforward definition of medical malpractice is that it is an act of wrongdoing, a sort of negligence by a medical practitioner in diagnosing or administering treatment that leads to ... Views: 920
Summary: MentorHealth, a leading provider of online training for the healthcare industry, is organizing a webinar on October 11 on the topic, “Setting up a Compliance Program That Will Protect and Improve Your Operations”. Joseph Batte, President of Kristall Associates, will be the speaker at ... Views: 895
Summary: MentorHealth, a leading provider of online training for the healthcare industry, is organizing a webinar on October 25 on the topic, “Setting up a Compliance Program: Training is Key”. Joseph Batte, President of Kristall Associates, will be the speaker at this session. ... Views: 892
One of the major fallouts of the passage of the Affordable Care Act (ACA) or Obamacare is the phenomenal rise in the number of physician practice acquisitions. These are some of the reasons for this rise:
Because of physician practice acquisitions, healthcare providers can consolidate and ... Views: 891
Summary: A webinar on the topic,“GHS and Hazard Communication”, is being organized on October 4 by MentorHealth, a leading provider of online training for the healthcare industry. Kenneth S. Weinberg, an independent consultant in environmental health and safety, will be the presenter at this ... Views: 877
Summary: Kenneth S. Weinberg will be the speaker at a webinar being organized by MentorHealth, a leading provider of online training for the healthcare industry. The topic of the webinar, which will be organized on October 18, will be “Blood Borne ... Views: 874
Summary: “HIPAA and Business Associates –New Rules and New Obligations” is the topic of a webinar that MentorHealth, a leading provider of online training for the healthcare industry, is organizing on October 11. Jim Sheldon-Dean, founder and director of compliance services at Lewis Creek ... Views: 870
MentorHealth webinars are designed to offer professionals in the healthcare industry the knowledge they need in all the areas of the healthcare industry that enables them to excel in their professions. MentorHealth’s trainings bring experts from all the core areas of healthcare and impart ... Views: 851
HIPAA and suing are two important elements closely related to each other. When HIPAA and suing are discussed, what needs to be borne in mind is that an individual cannot sue HIPAA. Yes, you are reading it right. An individual cannot sue a Covered Entity or Business Associate for violation of ... Views: 842
Summary: “The Science of Safe Patient-Centered Care” is the topic on which MentorHealth, a leading provider of online training for the healthcare industry, is organizing a webinar on October 16. Dev Raheja, faculty at Florida Tech University, will be the speaker at this ... Views: 832
A proper understanding of the Anti-Kickback Statute (AKS) is completely necessary for healthcare providers and professionals. It is among the strongest weapons in the government arsenal for enforcing the federal fraud and abuse laws. Along with Stark II (the federal physician anti-referral ... Views: 829
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a federal Act that determines the way in which physicians need to be paid when they treat patients who come to them under Medicare. It substantially alters and replaces the earlier Act in this regard, namely the Balanced Budget ... Views: 820
Stark Law, more formally referred to as The Physician Anti-Referral Law (known as Stark II), is a prominent law concerning physician referrals. Healthcare providers that file claims require compliance with the Stark rules. Failure to comply can invite an enforcement action. The fundamental aim ... Views: 804
Ransomware and HIPAA risks are now inseparable. After a lot of deliberation, ransomware has now become part of HIPAA compliance for Business Associates and Covered Entities that have to show HIPAA compliance. This became official on July 11, 2016, when the HHS issued a new guideline that makes ... Views: 791
With HIPAA now being fully enforced and the government getting stricter and stricter about its implementation; practice or business or compliance officers need to be absolutely thorough about all the areas of HIPAA implementation. Given that there are enormous issues of risks that Covered ... Views: 785
Hospital management is one of the giant areas of healthcare in the US, estimated at over $ three trillion. This is the world’s largest healthcare market by a long stretch. The sheer size of this market, however, belies the realities that hospital management has to face in their daily ... Views: 767
Understanding HIPAA compliance requirements is the foundation to meeting the legal requirements required of a healthcare provider. Understanding HIPAA compliance involves being knowledgeable about the proper policies and procedures in place, because being in compliance with HIPAA is as important ... Views: 764
In many years that it has been in existence, one of the noticeable changes that HIPAA has undergone is in its attitude. The earlier phase of advice and counseling has now given way to hardboiled and unforgiving enforcement. The Office of Civil Rights (OCR) no longer uses the cajoling and ... Views: 752
Whistleblowing is a very important area of the healthcare industry. When exercised properly and with integrity, it helps expose major frauds and saves the industry from many malpractices. There have been instances of whistleblowers bringing many companies into the legal net and helping save ... Views: 752
Food technology has been growing at a quick pace, having come under the influence of the twin paradigms of the late 20th century, technology and globalization. As populations keep moving from one part of the world to another in the millions; it is natural that they get influenced by the food ... Views: 751
By their nature, clinical trials are at times large complex projects that take years to complete. They involve many different resources, and are covered by extensive federal regulations. Regulations have been enacted with the purpose of documenting the efficacy of the treatment, as well as to ... Views: 746
The US Health and Human Services (HHS) conducts periodic audits of providers and Business Associates to ensure their compliance with the HIPAA Security and Privacy Rule, and to make sure they are in accordance with breach notification standards. This is mandated in Section 13411 of the Health ... Views: 744
Stark Rules require Physician Leases to be properly structured and audited. An important law about physician referrals in the US is the Stark Law. Short for The Physician Anti-Referral Law (known as Stark II), the Stark Law requires compliance with its provisions by healthcare providers that ... Views: 736
Protected Health Information (PHI) is a very valuable piece of information. It is valuable for the patient, for the healthcare provider, and for the insurer. Unfortunately, there is one source to which it is more valuable than to all these: Hackers. Protected Health Information is meant to be ... Views: 733
Meeting the legal requirements required of a healthcare provider hinges on and depends directly on a clear grasp of HIPAA compliance requirements. A thorough grasp of HIPAA compliance entails being fully equipped with all the knowledge needed to put the proper policies and procedures in place. ... Views: 728
The major reason for which there are widespread violations of the HIPAA Rules for communicating with patients by unencrypted email and text message is that healthcare providers and Covered Entities and their Business Associates are ignorant of the rules. Although the HIPAA Rules are pretty ... Views: 721
It is imperative for any organization that is carrying out clinical research to have in place thoroughly and properly written and complete policies and procedures. These are the cornerstone for any well-functioning Institutional Review Board (IRB) and Human Research Protection Program (HRPP). ... Views: 720
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a federal Act that regulates the manner in which physicians have to be paid when they treat patients who come to them under Medicare. It modifies and supersedes the earlier legislation on this topic, namely the Balanced Budget ... Views: 719
Of late, there has been an explosion in the field of biopharmaceuticals in activities ranging from development to manufacture. Although this augurs well for the industry; there are concerns, nevertheless.
These concerns relate mainly to the inadequacy of the skillsets needed for this industry. ... Views: 710
Stark Law compliance is now more than just a compliance issue. It has grown to become an Enterprise Risk Management matter, if the substantial awards and settlements in recent enforcement actions are anything to go by. For healthcare organizations that develop and implement provider contracts; ... Views: 708
This Article focuses on the issues of managing health information when it may that of students and may involve substance abuse treatment information. HIPAA and FERPA allow a number of disclosures without consent that SAMHSA prohibits without consent.
how HIPAA relates to information management ... Views: 705
The final regulations for the new HIPAA Breach Notification Rule place a far greater burden on Covered Entities and Business Associates than earlier. It is not enough for them to just notify individuals whose Protected Health Information (PHI) have been affected. For them to determine if a ... Views: 702
Is the US hospital management sector waiting for the next big thing in hospital management? What is it going to be and what shape is it going to take? Any change in the hospital management sector needs to be watched for, because it is part of the $ three-trillion healthcare sector in the US, the ... Views: 692
The introduction of the Electronic Health Record (EHR) has certainly brought about a major change in the way healthcare is administered in this vast country.
EHR's have evolved in a big way from the time they first came to be used in a moderate way in the healthcare industry a few decades ago. ... Views: 687
Health care boards are an important element of healthcare governance. These health care boards have oversight of a number issues relating to governance. The US Department of Justice (DoJ) has tightened the oversight functions of health care boards by holding them responsible for any fraud that ... Views: 686
The medical profession is different from most others in one vital aspect: Practitioners of this profession don’t retire. The profession allows the physician to continue for as long as her physical and mental faculties allow her to. The US’ Supreme Court judges too, don’t retire, but theirs is ... Views: 679
Perhaps no educational campus is free of students with some or another kind of mental or emotional issues. Considering the wide diversity of students that enroll into American colleges and the varied backgrounds they come from; it is no surprise that American colleges will have to deal with such ... Views: 679
The Office of Inspector General (OIG) has oversight of protection of the integrity of Health and Human Services (HHS) programs and operations. The aim of this function is to ensure the wellbeing of American people who benefit from these programs. The OIG seeks to prevent fraud, abuse and waste, ... Views: 676
Medical coding has been around as a profession in the healthcare insurance sector for a while now. Let us get down to understanding medical coding then. Medical coding is a practice in which the full set of medical data relating to a patient, which could range from diagnosis to medication, is ... Views: 672
HIPAA has regulations concerning the use of the mobile devices to access Protected Health Information PHI). Secure technologies for communications and storage of data should also be considered when using portable technologies. Due to these requirements, the use of portable devices by patients ... Views: 666
Since the Affordable Care Act (ACA) –popularly called Obamacare –came into existence, there has been an exponential increase in the number of physician practice acquisitions. Some of the reasons that can be ascribed for this phenomenon are these:
Physician practice acquisitions are an ... Views: 663
It goes without saying that preparing for HIPAA enforcement is of crucial importance to organizations. The reason: Last year saw a spike in the settlement payments ordered by HIPAA. There were as many as seven settlements of a value of over $1 million each. Of these seven, one was for $5.5 ... Views: 662