NASHP

APRIL 18, 2024

Resources for Effective PDAB Implementation In partnership with NASHP, PORTAL has developed the following publications to offer information and considerations relevant to state PDABs conducting affordability reviews and setting upper payment limits.

Regulations 75

Regulations Hospitals 75

p3care

MAY 1, 2023

Fraudulent actions put patients’ trust and security in danger. In this blog, we will get to know the techniques for successfully identifying fraud in medical billing services. However, there are three categories we have for all sorts of medical fraud. We call it a kickback, self-referral, or pay-for-play scheme.

Patient Safety 130

Patient Safety Healthcare Regulations Medicaid 130

p3care

DECEMBER 17, 2023

We know that every category of MIPS reporting has separate data completeness requirements. Well, that’s what the blog for today is about. So, this blog is a guide for all MIPS reporting participants, old or new. On the basis of the submitted data, CMS makes the payment adjustments.

Medicare 100

Medicare Healthcare 100

p3care

JULY 6, 2023

Every provider has complete awareness of the Quality Payment Program. This blog primarily highlights different tips and strategies. Also, the participants have to get more than 75 points for positive payment adjustments. encouraging patient participation via patient portals or encrypted communications.

Performance improvement 130

Performance improvement Medicare Healthcare 130

Healthcare Success

JULY 5, 2022

As marketing to doctors is such a vast topic, we’ve developed a 5-part blog series to help people in virtually every industry successfully market to physicians and other health care professionals. This is the first blog in the series. How to Market to Physicians and Doctors in Five Steps . doctors are treating most often.

Doctors 154

Doctors Private Practices Accountability Hospitals 154

Etactics

NOVEMBER 30, 2023

If you’re reading this blog, chances are that the company you work for works with HIPAA in some type of way. It’s a federal law that protects sensitive patient information within the healthcare industry. So on to the question that this blog is all about. Do HIPAA laws apply to employers? There isn’t 1 answer to this question.

Healthcare 52

Healthcare Healthcare Providers Accountability Doctors 52

Etactics

DECEMBER 1, 2023

If you keep up with our blogs or work in the industry, you know exactly what I’m talking about. This is an easily preventable billing error, which we are going to go over in this blog. C Codes - Temporary outpatient hospital prospective payment system. For multiple patients, use code R0075. D Codes - Dental procedures.

Medicare 52

Medicare Medicaid Medical Services Rehabilitation 52

Etactics

APRIL 19, 2022

Not to mention the direct relationship that exists between increasing your patient volume and your organization’s operating risk. That last sentence hinted at the entire reason why you’re reading this blog post in the first place. And one of those tools is HIPAA-compliant payment processing. Mobile payments.

Regulations 52

Regulations Accountability Healthcare Healthcare Providers 52

Etactics

FEBRUARY 23, 2024

Better quality of life for patients while reducing ER visits and readmission rates. Physical therapy in younger patients due to sports injuries. In order to stay in business, you need to be able to collect payments in a prompt and timely manner. The growth of this industry stretches beyond needing more physical therapists.

Physical Therapy 52

Physical Therapy Medicare Rehabilitation Medicaid 52

Briggs Healthcare

AUGUST 1, 2023

The associated CMS Fact Sheet: Fiscal Year (FY) 2024 Skilled Nursing Facility Perspective Payment System Final Rule – CMS-1779-F is also a valuable read to begin your review of the Final Rule. Payment for SNF-Level Swing-Bed Services D. SNF Value-Based Incentive Payments for FY 2024 I. SNF Value-Based Purchasing Program F.

Regulations 52

Regulations Nursing Medicare Healthcare 52

NASHP

DECEMBER 19, 2022

Parity in payment for telehealth services and in-person services is also inconsistent across states, though COVID-19 has provided an impetus for states to change this policy. Recently, California expedited legislation that required payment parity for telehealth services within both Medicaid and commercial insurance.

Medicaid 52

Medicaid Regulations Prevention Primary Care 52

Health Populi

JANUARY 2, 2024

A decade+ later, we see the maturing of the patient-as-consumer, taking on more self-care beyond fitness and wellness blurring into medical and acute care as hospitals re-locate services and monitoring to people at home and people becoming more activated in tracking chronic conditions, from head-to-toe.

Hospitals 81

Hospitals Healthcare Medical Technology Patient Experience 81

Sheppard Health Law

FEBRUARY 28, 2023

Pursuant to the 2023 Consolidated Appropriations Act (“CAA”), certain telehealth flexibilities (including with respect to provider and patient location) will be extended through December 31, 2024. [1] Upon the end of the PHE, an established relationship with the patient prior to providing RPM services will once again be required.

Medicare 52

Medicare Nursing Medicaid Healthcare 52

Etactics

MAY 11, 2023

So we are here to help you with this blog! Revenue codes are a standardized system that identifies any accommodations and specific services provided to patients in a healthcare setting. These codes not only tell the insurance company what kind of service the patient receives but as well as where in the hospital they received it.

Physical Therapy 52

Physical Therapy Urgent Care Quality Assurance Hospitals 52

Etactics

JANUARY 18, 2023

Or, the provider’s charge may exceed the customary amount for which a patient is responsible. CO denials make it so providers cannot place financial responsibility on their patients or beneficiaries. PR” stands for “Patient Responsibility”. For the sake of this blog, let’s focus on the CO group code.

Healthcare 52

Healthcare Healthcare Providers 52

Etactics

MARCH 29, 2022

80% of patients prefer to pay for their healthcare online. First, patients want to pay their medical bills over the internet. Second, they would likely want to use Apple Pay as a payment option. From your perspective as a healthcare provider, you want to make your patient payment options as convenient as possible.

Regulations 52

Regulations Healthcare Providers Healthcare Accountability 52

Healthcare Success

JULY 11, 2022

In this blog post, I share: What is Google Analytics 4 (GA4)? For example, suppose most of your patients prefer using desktops to fill out new patient forms ahead of their appointments but mobile devices to schedule appointments. Google Analytics 4 makes it easier to track patients across all of your platforms.

Healthcare 242

Healthcare Patient Experience Regulations Accountability 242

Sheppard Health Law

JANUARY 26, 2024

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

Medicare 52

Medicare Medicaid Hospitals Health Data 52

Etactics

SEPTEMBER 7, 2023

That’s just one of the key topics we’re going to cover in this blog. Based on the industry average, you see about 7 patients per day. If we take the overall denial rate from 2022 that we discussed in the introduction of this blog, 4 claims per week from the patients you see would get denied.

Healthcare 52

Healthcare Doctors Prevention Medical Services 52

Sheppard Health Law

MARCH 20, 2023

For example, an overwhelming sixty percent (60%) of recently-surveyed licensed psychologists reported having no openings for new patients, with many having a volume of patient requests that outweighs their ability to even maintain a waitlist. [1] 6] Increase provider reimbursement strategies.

Medicaid 52

Medicaid Medicare Healthcare 52

Etactics

APRIL 4, 2022

According to TransUnion almost half of all patients don’t pay off hospital bills of $500 or less. But even conquering all of those preliminary steps doesn’t guarantee payment. So, you send a bill and the patient received it. As a result, you resend it to the patient and include a past due letter within the envelope.

Accountability 52

Accountability Healthcare Integration Hospitals 52

NASHP

NOVEMBER 15, 2021

This report accompanies an increasing number of stories detailing AI’s shortcomings , such as a Science study that found that an algorithm commonly used in health systems disproportionally keeps Black patients from being included in targeted care outreach. Acknowledgements.

Quality Assurance 52

Quality Assurance Medicaid Population Health Prevention 52

Etactics

DECEMBER 21, 2021

Since both types of codes deal directly with the patient, they’re considered the front-end of the revenue cycle. Unfortunately, that also means both of those types of codes fall under the category that accounts for a lot of denials for healthcare organizations. Side effects include payment delays. See how things start cascading?

Accountability 52

Accountability Doctors Healthcare Patient Experience 52

NASHP

AUGUST 30, 2023

To learn more about this model act, check out our blog, Rural Emergency Hospitals: Model Legislation and Considerations for States. Transfer Agreement” means an agreement between a rural emergency hospital and a Level I or Level II trauma center for the transfer of patients requiring emergency services. See 42 U.S.C.

Hospitals 97

Hospitals Regulations Federal Healthcare Nursing 97

Sheppard Health Law

OCTOBER 27, 2021

The Innovation Center, established in 2010 as part of the Affordable Care Act, began as an initiative to transition the health system to value-based care by developing, testing and evaluating new payment and service delivery models in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).

Medicaid 52

Medicaid Medicare Accountable Care Accountability 52

Etactics

APRIL 12, 2022

In this blog post, we'll give you an overview of HIPAA compliance for dental offices. HIPAA compliance for dental offices exists in two main categories: covered entities and business associates. But, it's hard to stay compliant with the regulation if you don't know what HIPAA compliance for dental offices looks like. Table of Contents.

Regulations 52

Regulations Accountability Healthcare Prevention 52

Etactics

APRIL 11, 2023

Provide a service, submit a claim, and receive payment. The scheduler must collect accurate patient demographic information and insurance numbers. Registration must verify the patient’s information. Physicians need to ensure their documentation reflects the services performed while seeing the patient.

Prevention 52

Prevention Doctors Medicare Nursing 52

Health Populi

JANUARY 31, 2018

This places them on a very short list of connected health developers who have patiently developed clinical-grade health techs designed for the consumer market that have undergone regulatory scrutiny. These patients must be mindful of their risk for stroke: people with AFib have a 5x greater risk of stroke than others.

Doctors 81

Doctors Prevention Healthcare Accountability 81

Etactics

JULY 16, 2021

Maybe you just started a blog that provides accurate medical information to common questions as a way to increase your patient volume. Even if you don’t blog, new patients may stumble upon your website when looking to switch their provider. Patient testimonials are a popular tactic for getting new clients.

Healthcare 52

Healthcare Hospitals Regulations Accountability 52

NASHP

AUGUST 30, 2023

To learn more about this model act, check out our blog post, Rural Emergency Hospitals: Legislative and Regulatory Considerations for States. Transfer Agreement” means an agreement between a rural emergency hospital and a Level I or Level II trauma center for the transfer of patients requiring emergency services. See 42 U.S.C.

Hospitals 52

Hospitals Regulations Federal Healthcare Nursing 52

Etactics

JULY 1, 2021

But I’ll answer that question the long way for the rest of this blog post. These records include details about the entire patient encounter. Why Medical Coders are Still Needed Although essentially everything that can happen to a patient has a definable ICD code , there’s still a lot of grey areas within this field.

Regulations 52

Regulations Healthcare Accountability Doctors 52

Etactics

FEBRUARY 8, 2022

If you have a pile of timely filing denials, there’s still hope to receive payment for them…it’s just a matter of knowing what to do and how to execute the steps properly. That’s exactly why I’m writing this blog post, here are 3 effective appeal letter for timely filing samples. Simple enough, right?

Medicaid 52

Medicaid Healthcare Healthcare Providers 52

Home Health Care

OCTOBER 2, 2023

A lot of what we’ll discuss relates to workforce shortages and payment challenges, which are driving technology innovation. There’s a lot that you can do for remote patient monitoring and for drug adherence, and there’s all kinds of stuff that you can do with this technology. What about long term? Think of even accounting.

Home Care 98

Home Care Hospitals Accountability Healthcare 98

Health Populi

JANUARY 10, 2019

Fast forward to 2018, and Fitbit’s blog posted about women’s health tracking, using the words “menstruation,” “period,” and “sexual health.” The watch can track heart rate, has GPS, and can make mobile payments using Google Pay.

Doctors 96

Doctors Patient Experience Healthcare Healthcare Providers 96

Sheppard Health Law

NOVEMBER 13, 2023

The inclusion of MFTs and MHCs was spurred by the Consolidated Appropriations Act, 2023, which authorized payment for services furnished by these providers. Please refer to our January 5, 2023 , November 4, 2022 and May 16, 2022 blog posts for more information.

Medicare 59

Medicare Medicaid Regulations Integration 59

Health Populi

DECEMBER 13, 2021

This year-end/New Year 2022 post on my Health Populi blog will weave together many of the key findings from these consumer health/care reports that are most resonating with me and the work I’m doing…. machine learning, AI) and should be mindful about data privacy and ownership vis-à-vis transparency and patient control of personal data.

Medicaid 73

Medicaid Primary Care Medicare Integration 73

Sheppard Health Law

JANUARY 5, 2023

Add the Part C Kidney Health Evaluation for Patients with Diabetes measure; Add the Part D Concurrent Use of Opioids and Benzodiazepines measure; Add the Part D Polypharmacy Use of Multiple Anticholinergic Medications in Older Adults measure; and. Please refer to our blog posts of November 4, 2022 , October 31, 2022 , and May 16, 2022.

Medicare 52

Medicare Primary Care Medicaid Integration 52