American Medical Compliance

JUNE 21, 2024

The Department of Health and Human Services (HHS) estimated that improper payments in the Medicare and Medicaid programs exceeded $100 billion from 2016 to 2023. This involves promoting ethical behavior, encouraging open communication, and having a zero-tolerance policy towards FWA.

Medicaid 93

Medicaid Continuing Education Medicare Communication 93

Relias

JUNE 1, 2022

Coding and clinical documentation have never been more important in healthcare. “We You’ll need ongoing training for your staff to improve your clinical documentation and avoid the following coding disasters. The documentation and coding are appropriate on our end. Insufficient Clinical Documentation or Underreported codes.

Outpatient Clinic 52

Outpatient Clinic Retirement Legal Issues Medicaid 52

Relias

JUNE 1, 2022

Coding and clinical documentation have never been more important in healthcare. “We You’ll need ongoing training for your staff to improve your clinical documentation and avoid the following coding disasters. The documentation and coding are appropriate on our end. Insufficient Clinical Documentation or Underreported codes.

Outpatient Clinic 52

Outpatient Clinic Retirement Legal Issues Medicaid 52

Nursing Review

MARCH 31, 2023

Nursing Review spoke with professor Ahmed about how ChatGPT could improve nurse-to-patient relationships through better communication. When a healthcare worker might be struggling to communicate with a patient because of a language barrier, you could ask ChatGPT to translate medical information into various languages.

Communication 52

Communication Medicare Education 52

American Medical Compliance

AUGUST 7, 2024

Additionally, using secure communication channels for transmitting patient information ensures that data is protected during exchanges. CMS (Centers for Medicare & Medicaid Services) These regulations provide essential guidelines for healthcare providers participating in Medicare and Medicaid programs.

HIPAA 81

HIPAA Medicaid Medicare Legal Issues 81

Hospital Recruiting | Nursing

APRIL 1, 2020

The emergency decision by the Center for Medicare and Medicaid Services (CMS) on March 17, 2020 (and retroactively in effect beginning March 6, 2020) to pay for telehealth visits outside of rural areas has eased physician concern. CPT codes for billing purposes are available.

Telemedicine 73

Telemedicine Medicaid Medicare Licensing 73

American Nurse

DECEMBER 8, 2023

The Centers for Medicare & Medicaid Services won’t reimburse hospitals for the care of this condition and may apply a value-based penalty fee. Comprehensive documentation of any dysfunction in skin integrity aids early diagnosis and prompt treatment to improve overall outcomes. See Skin assessment guide.)

Clinical Nurse Specialist 98

Clinical Nurse Specialist Medicaid Medicare Communication 98

American Medical Compliance

OCTOBER 25, 2024

The healthcare industry is highly regulated, with various laws such as the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH), and the Medicare and Medicaid Services (CMS) regulations shaping operations.

HIPAA 85

HIPAA Medicaid Health Insurance Best Practices 85

Relias

SEPTEMBER 23, 2022

The percentage of Medicare hospice beneficiaries dying with a diagnosis of dementia or Parkinson’s disease, some of whom have dementia, has increased from 9% in 2002 to almost 21% in 2019, according to the National Hospice and Palliative Care Organization’s Facts and Figure Report 2021 Edition. Document care preferences in advance.

Medicare 52

Medicare Communication Education 52

American Medical Compliance

FEBRUARY 15, 2023

The impact of these losses and risks magnifies as Medicare continues to serve a growing number of beneficiaries. Even organized crime groups infiltrate the Medicare Program and operate as Medicare providers and suppliers. The Centers for Medicare and Medicaid Services (CMS) require FWA training.

Medicare 52

Medicare Medicaid Pharmaceutical Federal healthcare 52

American Medical Compliance

FEBRUARY 15, 2023

The impact of these losses and risks magnifies as Medicare continues to serve a growing number of beneficiaries. Even organized crime groups infiltrate the Medicare Program and operate as Medicare providers and suppliers. The Centers for Medicare and Medicaid Services (CMS) require FWA training.

Medicare 52

Medicare Medicaid Pharmaceutical Federal healthcare 52

Healthcare Law Insights blog

JUNE 5, 2023

In the 25 years since, the OIG has issued multiple and specific CPGs that apply to particular segments of the healthcare industry including Medicare Advantage organizations, hospitals, home health agencies, nursing homes, and clinical laboratories. 2] To join OIG’s listserv, visit [link].

Medicare 52

Medicare Federal healthcare Communication 52

American Nurse

FEBRUARY 29, 2024

Takeaways: The 1990 Federal Patient Self Determination Act requires that Medicare- and Medicaid-funded healthcare organizations follow state laws related to advance directives. Advance directives are legal documents that allow adults to record their wishes related to serious illness or end-of-life care. See Patient self-determination.

Self-Care 59

Self-Care Medicaid Medicare Nurse Practitioner 59

Healthcare Law Insights blog

OCTOBER 17, 2023

To best position the nursing home for the most successful outcome at the appeal hearing, the facility must follow specific rules and requirements as it discharges or transfers the resident and the facility must ensure it documents all necessary facts along the way. What documentation is required before sending the notice of discharge?

Long Term Care 59

Long Term Care Medicaid Medicare Communication 59

Relias

OCTOBER 28, 2022

Under the first performance year of VBP in 2023, home health agencies will be scored in part on the patient’s perception of their communication and team discussion.” Patient perception of communication and team discussion are two of those five elements. Assessing communication and collaboration. Increased scrutiny in hospices.

Care coordination 52

Care coordination Communication Medicaid Medicare 52

Celayix

FEBRUARY 7, 2023

Other common complaints from patients include poor communication, and lack of continuity. When it comes to home healthcare, there are multiple parties that require absolute transparency in their communications. There is also the patient family, and the patient insurance provider, or the government in the case of Medicare or Medicaid.

Home Healthcare 52

Home Healthcare Medicaid Business Medicare 52

Relias

DECEMBER 21, 2021

For Medicare claims, you already track care quality and report it to the Centers for Medicare and Medicaid Services (CMS). Those quality ratings appear on Medicare’s Care Compare website and inform prospective clients how well you’re achieving positive outcomes. Improve Your Quality Ratings.

Medicare 52

Medicare Medicaid Staff Training Home Healthcare 52

Relias

MARCH 13, 2023

As a result, the Centers for Medicare and Medicaid Services (CMS) public rule on price transparency requirements for hospitals came into effect on January 1, 2021. Finally, enlist a communication or UX specialist to evaluate all written materials for clarity and readability. Additional rules took effect in July 2022.

Medicare 52

Medicare Medicaid Self-Care Best Practices 52

Relias

FEBRUARY 26, 2024

It involves communicating and collaborating with patients, their families, and their health care teams to ensure that the patient’s needs and preferences are met and that the best possible outcomes are achieved. The team should document successes and address any challenges or issues that arise. What is care coordination?

Care coordination 52

Care coordination Patient Satisfaction Self-Care Emergency Care 52

Relias

JANUARY 30, 2024

Healthcare organizations receive scores from the HCAHPS survey , which according to the Centers for Medicare and Medicaid Services, is “the first national, standardized, publicly reported survey of patients’ perspectives of hospital care.” The data is then tabulated to create the HCAHPS score.

Patient Satisfaction 52

Patient Satisfaction Patient Experience Medicare Self-Care 52

Healthcare Law Insights blog

JULY 7, 2023

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. The hospital simply left things where they were.

Pharmaceutical 52

Pharmaceutical Medicare Medicaid Communication 52

Daily Nurse

SEPTEMBER 12, 2023

But most importantly, we had to facilitate the correct communication so patient care doesn’t suffer. So, whatever we do, we document it and get reimbursed. You’ll get better reimbursement from Medicare, the big blues, and everybody else in insurance. We can drive quality patient outcomes. So that’s part of it.

Nurse Shortage 126

Nurse Shortage Nurse Practitioner Education Travel Nursing 126

Healthcare Law Insights blog

NOVEMBER 10, 2023

Communicate the organization’s mission and ethical requirements. Having a method to keep track of, and review closely, financial relationships with physicians who refer Medicare patients. Ensuring that proper supporting documentation is maintained, and regular legal reviews are conducted.

Leadership 59

Leadership Medicare Business Best Practices 59

American Nurse

OCTOBER 2, 2023

The SCALE document proposes that the skin isn’t impervious to dysfunction at the end of life and may include varying degrees of skin and tissue damage, including pressure injuries. Skillful communication and empathy can help prevent litigation. The result can include large and unusual presentations of skin failure.

Long Term Care 105

Long Term Care Malpractice Nurse Practitioner Medicaid 105

Hospital Recruiting | Nursing

JANUARY 3, 2022

RVUs or Relative Value Units are part of the formula Medicare uses to quantify the complexity of work and expense a practice generates seeing patients. Every type of encounter is assigned an RVU value by Medicare. For those unfamiliar with the terminology, advanced practitioner Russell Singleton breaks down the concept of RVUs here.

Medicare 59

Medicare Malpractice Pharmaceutical Long Term Care 59

Relias

FEBRUARY 1, 2023

We communicate the change to the pharmacy team. Some Medicare Advantage plans are denying authorization for hospitalization. At Emory Healthcare, better documentation and reporting through the Epic system resulted in their Denial Management Action Plan. This process avoids delays in authorizations and denials,” said Beland.

Physician Office 10

Physician Office Medicare Retirement Education 10

American Nurse

JUNE 13, 2024

Use of NPIs allows advanced practice nurses to bill Medicare and Medicaid for services provided to patients. million to support four projects led by nurses that document nurses’ value to health care and create a road to reimbursement for nursing care. The Foundation granted $5.5

Health Outcomes 52

Health Outcomes Medicaid Medicare Nurse Educator 52

Relias

AUGUST 9, 2023

Tis the season for evaluating training programs and checking everything twice to make sure you’re on the Center for Medicare and Medicaid Services’ and The Joint Commission’s nice lists. The best-made plans are laid to waste if there’s no effective communication from the top down within an accessible channel.

Best Practices 52

Best Practices Education Medicaid Medicare 52

American Nurse

JULY 3, 2024

Patient-centered care focused on self-sufficiency The Centers for Medicare and Medicaid Services (CMS) uses the term “home health” to describe a federal health insurance program that provides intermittent short-term care to help patients recover from illness and become as self-sufficient as possible at home.

Self-Care 40

Self-Care Health Literacy Medicare Home Healthcare 40

Relias

OCTOBER 10, 2022

Recently, the Centers for Medicare and Medicaid Services’ (CMS) Special Focus Facility Program report listed nursing homes that have not met the CMS’ health care or fire safety standards. Respectful communication and appropriate behavior. Audit coding and billing to ensure clinical documentation integrity. Think like a surveyor.

Medicaid 52

Medicaid Medicare Self-Care Licensing 52

American Nurse

SEPTEMBER 12, 2024

Violations may lead to civil monetary penalties, loss of Medicare certification, and potential legal action against the individual nurse or healthcare facility. ED nurses can enhance communication skills by actively listening, having empathy, and using non-judgmental communication with these patients (Navas et al.,

Mental Health 52

Mental Health Medicare Emergency Care Communication 52

Relias

JULY 20, 2023

­The Centers for Medicare and Medicaid Services (CMS) issued a final rule in August 2022 to improve maternal health outcomes and advance health equity — two of the Biden-Harris Administration’s key priorities. Maternal mortality is closely linked to social and behavioral factors As documented extensively, higher U.S. Sadly, U.S.

Medicaid 40

Medicaid Mental Health Health Insurance Medicare 40