Compliance with rules and standards is essential to ensure patient safety, data security, and ethical practices in the complex world of healthcare. It should not be surprising that healthcare is heavily regulated and that the penalty for noncompliance are severe given that it is a multi-trillion dollar sector centered on patient care and safety. There […]
Clinical documentation is extremely essential in the ever-changing healthcare environment for accurate and thorough patient treatment. The quality of healthcare delivery, revenue cycle management, and regulatory compliance are all greatly impacted by proper documentation in addition to ensuring greater communication among healthcare professionals. Clinical Documentation Improvement (CDI) is a methodical strategy that aims to improve […]
Managing medical bills can be a difficult and intimidating undertaking for a lot of individuals. Understanding the payment process and identifying strategies to reduce the financial load is critical in light of escalating healthcare prices and complex billing systems. This step-by-step guide is intended to provide useful insights and practical recommendations to assist you in […]
Medical emergencies can occur at any time, and dealing with the aftermath can be difficult enough without the extra stress of unexpected medical expenditures. These unexpected costs, often known as surprise medical bills or balance billing, can leave people with excessive fees for healthcare procedures they thought were covered by their insurance. The No Surprises […]
What is upcoding? “Upcoding” occurs when a healthcare provider submits codes to Medicare, Medicaid or private insurers for more serious (and more expensive) diagnoses or procedures than the provider actually diagnosed or performed. Healthcare providers use billing codes to identify the services and procedures that they provide to patients. Each code corresponds to a particular […]
Healthcare fraud is not a victimless crime. The Department of Justice (DOJ) estimates that healthcare fraud generates roughly $100 billion a year. Unfortunately, that means this type of crime happens all the time. What’s worse is that these schemes are hard to detect and understand. Oftentimes, perpetrators will commit one type of healthcare fraud to […]