Reimbursement
The healthcare industry is on notice: Fraud recoveries in the healthcare sector are on the rise and whistle-blowers are the biggest weapon in the fight against fraud.
In the last few years the scope of responsibilities and duties delegated to medical directors has been evolving to include more responsibility over measures of quality within their healthcare organizations.
Continuing the upward trajectory of EHR reimbursements flowing out into the healthcare industry, the Centers for Medicare & Medicaid Services said on Tuesday morning that the total paid as of March's end is more than $13.7 billion.
CMS's Center for Consumer Information and Insurance Oversight (CCIIO) has outlined the roles for traditional insurance brokers and web-based brokers assisting customers in public exchanges.
An analysis from HealthPocket raises the specter that individuals who obtain health coverage under expanded Medicaid starting in 2014 will have to dig to find a clinician who will treat them.
An analysis from HealthPocket raises the specter that individuals who obtain health coverage under Medicaid starting in 2014 will have to dig to find a clinician who will treat them.
Getting uninsured Americans covered by insurance is not just a goal of the federal government's. It has also become a goal of the American Hospital Association's and at its annual membership meeting in April, a panel discussion focused on how to reach that goal.
When it comes to paying for new procedures or new ways of delivering care, private insurers often keep their eyes on payment policies from the Centers for Medicare & Medicaid Services. If CMS begins compensation for a service, the private payers will likely follow. But that rule of thumb may not apply in the new world of reimbursing for telemedicine and telehealth services.
Electronic health records, when used correctly, produce more accurate documentation leading to more complete coding, and ultimately, more accurate reimbursement claims, according to Sue Bowman, senior director of coding policy and compliance of the American Health Information Management Association.
Every week, I get an email from the Maryland Health Connection -- the state run health insurance exchange. Maryland is one of a minority of states that are building their own Affordable Care Act ("ObamaCare") exchange.