CMS Increases Scrutiny of Owners through Medicare Provider Enrollment Process

Published: Mon, 09/16/19

The Centers for Medicare & Medicaid Services (CMS) issued a final rule on September 5, 2019, intended to address program integrity and vulnerability issues. The Office of the Inspector General (OIG) testified before Congress in 2011 that fraud schemes relied on the use of networks of affiliations among...

AI helps physicians with no coding experience create automated tools: study

Using automated deep learning software, physicians without any background in computer programming were able to develop effective artificial intelligence technology for medical image diagnostic classification, a recent study found.

Skilled Nursing Facilities and the Three-Day Stay

Today I want to talk about skilled nursing facility, or as we often call them, “SNF” stays. For this, I’d like to start at the beginning. I’ll go all the way back to the Social Security Act. The reason to start there is that I’m often asked, why do SNFs require a three-day stay?”

OIG tags California medical group for erroneous billing

Santa Monica, Calif.-based Oceanside Medical Group failed to comply with Medicare requirements when billing for psychotherapy services, according to a report from HHS' Office of Inspector General. The OIG said none of the 100 sampled beneficiary days, consisting of 103 psychotherapy services, complied with Medicare requirements. In the...

Bringing Coding Compliance into the Digital Age Prevents Denials

Healthcare technology is credited with advancing clinical care, allowing providers to detect cancer by scanning radiology reports, improve\ chronic disease management standards, and enhance patient safety. But hospitals have yet to bring the same types of...

ICD-10-CM changes take effect Oct. 1. What you should know

Pediatrics will see some important changes to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) that will take effect on Oct. 1. These include updates to both the tabular and the code set.

Blockchain Can be A Promising Tool in Health care

The revolution in Blockchain technology has made its way to the healthcare industry and is already showing promising results in the technical advancements in health care. Healthcare Rallies For Blockchain, a study from IBM, found that 16% of surveyed healthcare executives have solid plans to implement a commercial blockchain...

CMS Rolls Out New Powers to Target Healthcare Fraud

Federal healthcare oversight authorities have announced that they are expanding their “revocation and denial authorities” in an effort to enhance their efforts to fight waste, fraud, and abuse in the American healthcare system – marking a move all but guaranteed to trouble providers already concerned over...