Arkenea

JULY 12, 2024

Medical insurance verification software is developed to automate the process of verifying patients’ insurance coverages. This software is connected to the insurance company’s database to retrieve real-time data on a patient’s insurance status. CDC reveals that 10.9 CDC also reveals that 3.9 In 2022, 92.1

Insurance 52

Insurance EHR / EMR Medication Patient Satisfaction 52

The HIPAA Journal

APRIL 4, 2025

Dameron Hospital Notifies Patients About November 2023 Data Breach Dameron Hospital in Stockton, California, has recently sent notification letters to patients about a November 2023 data breach. Notification letters were mailed to the affected individuals on February 21, 2025.

Hospital 69

Hospital Follow-Up HIPAA Insurance 69

Minority Nurse

FEBRUARY 22, 2024

Financial Constraints and Budgetary Cuts Healthcare institutions often face financial constraints, with shrinking budgets and reduced reimbursements from insurance companies and government programs. link] Joint Commission (2023, August 24). link] Mcfanhn, C (2023, August 24). link] Muoio, D (2023, August 24).

Patient Care 111

Patient Care Hospital Critical Thinking Patient Safety 111

ACMA Blog

JULY 9, 2024

FTC Conducts Investigation into PBMs Because PBM practices lack transparency and accountability to the public, in 2022, the Federal Trade Commission (FTC) requested data and documents of business practices to the six largest PBMs: Caremark Rx, LLC, Express Scripts, Inc., pharmacies in 2023. OptumRx, Inc., drug prescriptions.

Insurance 98

Insurance Patient Centered Care Medication Certification 98

The HIPAA Journal

MARCH 7, 2025

A further hacking incident was experienced in 2021 and was disclosed by Apria Healthcare in May 2023. Hackers had access to its network between August 27, 2021, and October 10, 2021, and potentially viewed or obtained personal, medical, health insurance, and financial information.

HIPAA 81

HIPAA Documentation Insurance Medication 81

Valant

JULY 29, 2024

This code is acceptable to insurers when used to describe a marked change in mental health status not attributable to other factors. Check out the 2023 ICD-10 updates here. Altered mental status, unspecified (R41.82) is a billable ICD-10 diagnostic code under HIPAA regulations from October 1, 2020, to September 30, 2021.

Diagnostics 97

Diagnostics HIPAA Insurance Medication 97

Healthcare Law Insights blog

JULY 7, 2023

A handful of FCA circuit court decisions issued in 2023 are noteworthy as well. Importantly, although the court assumed the relator engaged in some protected activity, the court found that in many of her communications she, at most, characterized discrepancies in therapy documentation as mistakes or possible computer glitches, not fraud.

Transfers 52

Transfers Hospital Documentation Communication 52

The Healthcare Blog

APRIL 2, 2024

billion (or 60% of its total revenues) represent clinical and business services provided to United’s Health Insurance business. Source: 2023 UNH 10K For most of the past decade, Optum has been driving force of incremental profit growth for United. billion in 2023 (55% of total). in the third quarter of 2023.

Tests 132

Tests Hospital Insurance Medication 132

Health Prime

JUNE 22, 2023

According to a recent Precedence Research report , the gastroenterology market size 2023 is USD 54.56 Accurate gastroenterology coding and documentation Accurate coding and thorough documentation are the foundation of successful medical billing. billion, expected to grow to USD 93.8 Billion by 2032.

Best Practices 52

Best Practices Billing Medication Documentation 52

ACMA Blog

JUNE 25, 2024

It is the insurance or payers’ way of controlling costs by approving or denying certain medications, procedures, or devices that may not usually be covered or is on a higher tier on the formulary. Clinical Documentation Specialist (CDS): A CDS can help in the PA process by accurately documenting patient records.

Documentation 40

Documentation Medical Assistant Certification Insurance 40

The Healthcare Blog

MARCH 13, 2024

Many patients must contend with well-documented side effects such as nausea, diarrhea or the significant loss of lean body mass (ie. muscle) and bone density. Again, those are lifetime side effects. and some patients simply tire of giving themselves a weekly injection.

Documentation 96

Documentation Insurance Patient Care Medication 96

Healthcare Law Insights blog

NOVEMBER 21, 2023

The good news for administrators is that they are permitted to submit affidavits or other documents from outside the administrative record that show that the conflict of interest played no role in the decision-making. A documented history of arbitrary claims denials by the administrator. Reliance Standard Life Insurance Co. ,

Documentation 52

Documentation Follow-Up Medication Insurance 52

ACMA Blog

OCTOBER 16, 2023

It is the insurance or payers’ way of controlling costs by approving or denying certain medications, procedures, or devices that may not usually be covered or is on a higher tier on the formulary. Clinical Documentation Specialist (CDS) : A CDS can help in the PA process by accurately documenting patient records.

Medical Assistant 40

Medical Assistant Documentation Certification Communication 40

Health Prime

JUNE 22, 2023

According to a recent Precedence Research report , the gastroenterology market size 2023 is USD 54.56 Accurate gastroenterology coding and documentation Accurate coding and thorough documentation are the foundation of successful medical billing. billion, expected to grow to USD 93.8 Billion by 2032.

Best Practices 40

Best Practices Billing Medication Documentation 40

Healthcare Law Insights blog

AUGUST 28, 2023

4] From court documents, it appears the government argued that Dr. Elfenbein knew that the patients whose insurance would be billed for E/M services would be with physicians “less than five minutes,” [5] and that Dr. Elfenbein told employees that E/M services were “the ‘bread and butter’ of how we get paid.” [6] 11, 2023). [4]

Billing 52

Billing Tests Documentation Medication 52

Healthcare Law Insights blog

JANUARY 15, 2025

From 2018-2023, OCR observed a 102% increase in breaches affecting 500 or more individuals, with 167 million affected in 2023 alone. Attachments should be in Microsoft Word or Portable Document Format (PDF). On December 27, 2024, the U.S. population. [1] Follow the instructions at: [link] for submitting electronic comments.

HIPAA 52

HIPAA Business Associate Follow-Up Documentation 52

Relias

APRIL 10, 2025

Keep a record of all damages and take photographs for insurance and federal assistance purposes. Document recovery expenses for reimbursement Keep detailed records of all recovery costs, including temporary staffing, repairs, transportation, and equipment replacement. Include input from clinical, administrative, and facilities teams.

Transfers 52

Transfers Communication Long Term Care Documentation 52

ACMA Blog

OCTOBER 8, 2024

Many healthcare providers may prescribe treatments that are not considered routine or may be expensive, an insurance company may need prior authorization (PA) to determine whether they will cover what the healthcare providers recommends 4. The healthcare provider must get approval from the insurance company.

Medication 40

Medication Insurance Documentation Follow-Up 40

Relias

JUNE 1, 2023

More technology is not always the best solution In a recent healthcare provider survey , half of healthcare executives said the revenue cycle is a top priority for software investment in 2023. 5 – Educate clinicians on required documentation Clinicians sometimes omit important documentation.

Documentation 52

Documentation Admissions Follow-Up Scheduling 52

Relias

JUNE 1, 2023

More technology is not always the best solution In a recent healthcare provider survey , half of healthcare executives said the revenue cycle is a top priority for software investment in 2023. 5 – Educate clinicians on required documentation Clinicians sometimes omit important documentation.

Documentation 52

Documentation Admissions Follow-Up Scheduling 52

Relias

FEBRUARY 1, 2023

It will be imperative for medical practices and organizations to focus on their billing and denial management to maximize revenue in 2023,” noted Cristy Good, MPH, MA, senior industry advisory and coding expert at MGMA. Some insurance companies have a list of “preferred” infusion drugs and won’t pay for other drugs.

Insurance 10

Insurance Billing Documentation Hospital 10

The HIPAA Journal

DECEMBER 24, 2022

The Health Insurance Portability and Accountability Act of 1996 placed a number of requirements on HIPAA-covered entities to safeguard the Protected Health Information (PHI) of patients, and to strictly control when PHI can be divulged, and to whom. The table will be updated to include the multiplier for 2023 when it is officially applied.

HIPAA 124

HIPAA Business Associate Follow-Up Medication 124

Relias

APRIL 27, 2023

Better retention As many as 58% of medical practices said that staffing is their biggest challenge for 2023, according to an MGMA Stat poll. Top 10 healthcare revenue cycle training priorities with the best ROI What training topics are the most important for the healthcare revenue cycle in 2023? It’s hard even for experts to keep up.

Critical Thinking 52

Critical Thinking Follow-Up Billing Best Practices 52

ACI Medical & Dental School

OCTOBER 24, 2023

ACI Medical & Dental School Prepares Students for In Demand Healthcare Jobs ( Updated for 2023 ) The National Healthcareer Association (NHA) has released their 2023 Industry Outlook , which continues to show that jobs for allied health professionals in the US are growing at 13%, a much faster rate than other professions.

Medical Administrative Assistant 52

Medical Administrative Assistant Medical Assistant Certification Continuing Education 52

Minority Nurse

NOVEMBER 22, 2023

Shelise Valentine, RNC, MSN, C-EFM, CPPS, CPHRM, is the Director of Clinical Education, Healthcare Risk Advisors, part of TDC Group and chairs nursing, co-chairs obstetric and simulation initiatives, and directs risk management and obstetric education for insured hospital clients to improve patient safety and reduce malpractice risk.

Unit Organization and Environment 59

Unit Organization and Environment Patient Safety Hospital Best Practices 59

CareerStep

NOVEMBER 14, 2023

The American Medical Association (AMA) reported that as of spring of 2023, the U.S. They’re used for billing and insurance reasons. Think of it as a simplified language for a patient’s medical history, because every doctor and insurance company in the U.S But, what do medical coders and billers do?

Billing 52

Billing Medical Coding Medication Certification 52

Prism Career Institute

FEBRUARY 4, 2025

These medical professionals will often be asked to take patient calls, schedule appointments, and get necessary insurance information. They may even need to assist patients when filling out documents. Another important aspect of the position is updating patient files and organizing and filing their charts.

Medical Assistant 52

Medical Assistant Medication Tests Vital Signs 52

Arkenea

JANUARY 25, 2025

Key Takeaways A need to control substance usage and reduce medication errors is driving the e-prescribing market growth during the 2023-2030 timeframe. percent during the 2023-2030 timeframe. In 2021, the CMS published rules to implement an RTBT (Real-Time Benefit Tool) by January 2023.

Transfers 52

Transfers HIPAA Medical History Follow-Up 52

ACMA Blog

MAY 21, 2024

Through enhanced coding and charge capture, these algorithms analyze clinical documentation to propose precise medical codes, minimizing the risk of undercoding or overcoding while ensuring comprehensive coverage of billable services. Published April 3, 2023. www.revelemd.com. Accessed April 9, 2024. link] Jongsma KR, Sand M, Milota M.

Billing 40

Billing Documentation Patient Satisfaction Patient Experience 40

Arkenea

AUGUST 16, 2024

HCA Healthcare In July 2023, a Tennessee hospital and clinic operator was breached by threat actors who obtained and removed data from an external storage location containing formatted emails and calendar reminders for patients. Examples of Healthcare Cyberattacks 1. Maintaining patient confidentiality is just as important.

HIPAA 52

HIPAA Patient Records Medical History Clinical Operations 52

Ciox

NOVEMBER 20, 2023

The Impact Health plan policies are changing more frequently, forcing healthcare organizations to defend their documentation when denials occur. Denial Rates : In the first quarter of 2023, 15% of commercial claims were initially denied. This trend is not expected to change in 2024.

Documentation 40

Documentation Insurance 40

Arkenea

AUGUST 15, 2024

HCA Healthcare In July 2023, a Tennessee hospital and clinic operator was breached by threat actors who obtained and removed data from an external storage location containing formatted emails and calendar reminders for patients. Examples of Healthcare Cyberattacks 1. Maintaining patient confidentiality is just as important.

HIPAA 40

HIPAA Patient Records Medical History Clinical Operations 40

Arkenea

OCTOBER 10, 2024

In 2023, 725 data breaches were reported to OCR and across those breaches, more than 133 million records were exposed or impermissibly disclosed. Incorporation of privacy measures such as HIPAA (Health Insurance Portability and Accountability Act) compliance can safeguard healthcare data against potential cyber-attacks.

HIPAA 52

HIPAA Tests Transfers Patient Satisfaction 52

The HIPAA Journal

MAY 1, 2024

The forensic investigation and document review confirmed that the protected health information of more than 623,000 patients had been exposed. One of those lawsuits, Bonnie Maser v.

HIPAA 114

HIPAA Documentation Insurance Medication 114

ACMA Blog

OCTOBER 8, 2024

Their knowledge of insurance coverage, regulations in patient assistance, and health policy empowers healthcare providers with tools that reduce hurdles in treatment access. Disrupted care was measured as a share of physicians who “reported that patients abandon treatment due to authorization struggles with health insurers”.

Documentation 52

Documentation Medication Billing Follow-Up 52

Healthcare Law Insights blog

MARCH 12, 2024

Therefore, on August 3, 2023, the Departments of Labor, Health and Human Services, and Treasury (collectively the “Departments”) released a comprehensive proposed rule to the Mental Health Parity and Addiction Equity Act (“MHPAEA”). [5] The 2023 Proposed Rule is comprehensive. 4 2023), [link]. [5] 3, 2023). [6]

Documentation 64

Documentation Insurance Medication 64

Pulmonology Advisor - Practice Management

OCTOBER 13, 2023

The 2023 Medscape survey found that plastic surgery is now the happiest specialty, with 71% of physicians reporting they are “very happy” or “happy” outside of work. Striking a Work-Life Balance The 2023 Medscape Physician Lifestyle and Happiness Report also asked physicians, “How are you maintaining your happiness and mental health?”

Follow-Up 52

Follow-Up Scheduling Medication Hospital 52