Electronic Health Reporter

JUNE 16, 2021

The article Vyne Medical Launches Refyne, a SaaS Platform To Facilitate Electronic Submission of Medicare Audit Responses appeared first on electronichealthreporter.com. Purpose built for healthcare, Refyne is designed with the look and feel of a modern consumer-facing app and features to help optimize administrative workflows […].

Medicare 172

Medicare 172

Health Populi

FEBRUARY 27, 2024

The aspirational document sets out the mission that “every individual deserves the right to obtain health care that is comprehensive, equitable and compassionate.” Kudos to NABIP for developing this document and taking a leadership position in supporting health care as a civil right for all consumers, emerging as health citizens, in America.

HIPAA 354

HIPAA Public Health Telehealth Mental health 354

Healthcare IT News - Telehealth

MAY 13, 2022

As outlined in court documents , marketers identified Medicare and TRICARE beneficiaries to target for expensive medications – such as pain creams, scar creams, eczema creams and migraine medication – and durable medical equipment, including wrist, shoulder, knee and ankle braces. " WHY IT MATTERS. ON THE RECORD.

Telehealth 172

Telehealth Medicare Federal healthcare Telemedicine 172

Healthcare IT News - Telehealth

FEBRUARY 22, 2021

Among the allegations are that Wolfe and her conspirators submitted well over $400 million in illegal durable medical equipment claims to Medicare and the Civilian Health and Medical Program of the Department of Veterans, relying on the guise of "telemedicine" to explain the unusually high volume of claims. THE LARGER TREND.

Telemedicine 199

Telemedicine Medicare Telehealth Healthcare IT 199

Healthcare IT News - Telehealth

JULY 9, 2020

The Centers for Medicare and Medicaid Services has put together further detailed guidance for how healthcare providers should be documenting and reporting electronic clinical quality measures for telehealth encounters.

Telehealth 216

Telehealth Primary Care Interoperability Medicare 216

Health Populi

OCTOBER 22, 2024

The green circle diagram from Deloitte’s report documents a growing willingness among patients to use virtual health services, increasing from 80% of consumers willing to use telehealth in 2020, 84% in 2022, and 94% in 2024.

Digital Health 156

Digital Health Mental health Telehealth Medicare 156

Healthcare IT News - Telehealth

SEPTEMBER 20, 2021

"We have seen all too often criminals who engage in health care fraud – stealing from taxpayers while jeopardizing the health of Medicare and Medicaid beneficiaries," said Deputy Inspector General for Investigations Gary L. More than $1.1 billion of that loss involved allegedly fraudulent claims related to telemedicine.

Telehealth 206

Telehealth Telemedicine Medicare Federal healthcare 206

Healthcare IT Today

OCTOBER 23, 2024

The following is a guest article by David Lareau, CEO at Medicomp Systems A couple of years ago, we predicted an impending “explosion” of Medicare Advantage (MA) fraud and penalties. For instance, an LLM might create documentation stating a patient has diabetic cataracts when they actually have age-related (senile) cataracts.

Medicare 75

Medicare Interoperability Healthcare Innovation Healthcare IT 75

Healthcare IT News - Telehealth

JANUARY 30, 2023

While it made "significant" changes to the Medicare Benefits Schedule (MBS), the expanded telehealth services were "only partly supported by sound implementation arrangements." " The audit found that it did not require key implementation decisions and plans to be documented.

Telehealth 188

Telehealth Psychiatry Medicare Health Policy 188

Healthcare IT News - Telehealth

JUNE 16, 2020

“We also needed to be able to conduct patient visits while simultaneously documenting the encounter, without disruption to our workflow,” he explained. Additionally, the technology enables him to document while he is doing a patient visit without losing eye contact.

EHR 211

EHR Telehealth HIPAA Nursing 211

FierceHealthIT

AUGUST 21, 2018

The Department of Justice is asking a court to compel Anthem to release testimony pertaining to a Medicare Advantage fraud investigation and the insurer's use of retrospective chart reviews. Court documents also indicate federal prosecutors may be close to filing a complaint against the insurer.

Medicare 80

Medicare 80

Healthcare IT News - Telehealth

APRIL 10, 2019

The illegal kickback scheme allegedly involved companies that received money in exchange for referral of Medicare beneficiaries by medical professionals for back, shoulder, wrist and knee braces that are medically unnecessary. WHY IT MATTERS. billion in losses. ON THE RECORD. WHAT ELSE TO KNOW.

Telemedicine 167

Telemedicine Medicare Healthcare IT 167

Healthcare IT Today

OCTOBER 19, 2024

John summarized a study in the American Journal of Managed Care highlighting how real-time interventional analytics reduced 30-day readmissions and Medicare spending per beneficiary for Penn Medicine affiliates. Read more… Supporting the Complete Path of Incoming Healthcare Documents.

Healthcare IT 90

Healthcare IT Health science Interoperability Medicare 90

Healthcare IT News - Telehealth

OCTOBER 27, 2020

The Centers for Medicare and Medicaid Services announced earlier this month , for example, that it would add 11 virtual services to its reimbursement list during the COVID-19 public health emergency – following in the footsteps of its earlier flexibilities for virtual care.

Telehealth 202

Telehealth Medicare Primary Care Healthcare IT 202

FierceHealthIT

SEPTEMBER 19, 2018

Recovery audit contractors (RACs) returned $214 million to the Medicare program in fiscal year 2016. of Medicare expenditures, and one organization says the program is hampered by limits on documentation requests. But that represents less than 0.1%

Medicare 60

Medicare 60

Healthcare IT Today

APRIL 5, 2025

Gupta talked to John about the importance of automating clinical tasks that distract from the core task of patient care , such as documentation, coding, and prior authorization. Read more… Unpacking Automated Document Processing and Information Extraction. The most interesting conversation to me?

Life Science 60

Life Science Healthcare IT Healthcare Cybersecurity Digital Health 60

Healthcare IT Today

NOVEMBER 22, 2022

The number of Medicare TPEs and commercial payer take-back audits alone is skyrocketing. They also look to flag “items and services that have high national error rates and are a financial risk to Medicare.” Meanwhile, Medicare also has a Fee for Service Recovery Audit Program. Tricare and Medicare).

Medicare 107

Medicare Private practice RCM Nursing 107

Healthcare IT News - Telehealth

SEPTEMBER 2, 2021

Department of Justice announced this week that a Florida laboratory owner had pleaded guilty for his role in a $73 million Medicare kickback scheme. The scheme, as outlined in court documents, exploited COVID-19-era amendments to telehealth restrictions. WHY IT MATTERS.

Telehealth 165

Telehealth Medicare Public Health Federal healthcare 165

Healthcare IT Today

JANUARY 17, 2024

Many include tight deadlines for initial response and appeals and have substantially greater Audit Documentation Request (ADR) letters that in some cases exceed 100 pages. Higher denial rates and increasing audit demands underscore the need for operational efficiency in billing, coding, and clinical documentation to enhance profitability.

Medicare 122

Medicare Health IT Healthcare IT Leadership 122

Healthcare IT News - Telehealth

MAY 13, 2020

Although research supported the efficacy of video telepsychiatry, the National Institute of Mental Health-funded study notes, only 5% of psychiatrists in the Medicare program had ever provided a telemedicine visit. The shift to telemedicine was made simpler, researchers note, by regulatory and reimbursement changes.

Telemedicine 218

Telemedicine Private practice Mental health HIPAA 218

Healthcare IT Today

JANUARY 26, 2025

Ambient AI documentation from DeepScribe is now integrated with Flatiron Health’s OncoEMR. Collaboration vendor Bamboo Health is partnering with Radial , a decision support vendor, to help Medicare ACOs provide more targeted interventions. Aidoc is collaborating with Amazon Web Services to optimize clinical AI foundation models.

Life Science 66

Life Science EHR Medicare Healthcare IT 66

Health Populi

AUGUST 25, 2020

In my new book on Health Citizenship , to be published in September 2020, I document the growing ethos among many health consumers I coin as the “fear of going out” — the opposite life-flow to some peoples’ “fear of missing out,” or FOMO.

Telehealth 427

Telehealth Primary Care Mental health Telemedicine 427

BHM Healthcare Solutions

MAY 24, 2023

Medicare Advantage growth aggravates prior authorization burdens in the several ways. Most medical groups, providing care to patients with Medicare Advantage plans, must comply with more prior authorization requirements. References: Centers for Medicare & Medicaid Services. American Medical Association. Prior Authorization.

Medicare 52

Medicare 52

Healthcare IT News - Telehealth

AUGUST 30, 2021

In 2017, the health system – which has 100 continuing care locations, including home care, hospice, PACE programs and senior living facilities – was in a bind, facing double-digit hospital readmissions of 16% across its high-risk Medicare population. "Document all of this essential information in a scope statement.

Nursing 195

Nursing Medicare Connected Health Leadership 195

Telebehavioral Health Institute

JANUARY 17, 2023

While the official end of the public health emergency (PHE) was extended to April 2023 for many federal government programs, two federal actions will further extend the deadline for federal Medicare reimbursement until at least December 31, 2024. Other repercussions of the end of the PHE include the return of HIPAA and licensure enforcement.

Public Health 98

Public Health HIPAA Mental health Medicare 98

FierceHealthIT

NOVEMBER 5, 2019

Up in arms a year ago, physician groups found a lot to like in Medicare’s new approach to evaluation and management (E/M) services finalized in the 2020 physician fee schedule.

Medicare 66

Medicare 66

Continue Education Journal

DECEMBER 30, 2021

BIR can include the costs of a provider verifying that a patient is eligible for services, prior authorization procedures on both provider and payer side, submitting bills and appropriate documentation, addressing denied claims, and remitting payment. of BIR is unnecessary. With the majority of payers in the U.S.

Interoperability 246

Interoperability Health Information EMR Medicare 246

FierceHealthIT

JUNE 12, 2019

HHS recently released two documents that address the lack of reporting when it comes to incidents of abuse and neglect of Medicare beneficiaries in skilled nursing facilities (SNF).

Nursing 83

Nursing Medicare 83

Healthcare IT News - Telehealth

JANUARY 6, 2021

Watauga Medical Center is a Medicare five-star-rated hospital and wanted a telehealth company that could provide the same high quality of care. "They would not use our hospital's medical records, and they wanted to send us a specific document that we need to configure on our own to be able to incorporate into our own records.

Telehealth 211

Telehealth Telemedicine Nursing Leadership 211

Healthcare IT News - Telehealth

JUNE 26, 2020

Providers also were trained on best practices regarding electronic health records and documentation; the Northwell team encouraged them to practice mock consultations with friends or family, and to be open to direct feedback from those loved ones. "Everybody needs to practice," said Spooner.

Primary Care 202

Primary Care Telehealth Telemedicine Medicare 202

Healthcare IT Today

DECEMBER 28, 2024

Our community experts expect more refined use cases for automation , especially when it comes to documentation and prior authorization. Read more… Bonus Features for December 22, 2024: 83% of providers want virtual care to be a permanent part of their practice; meanwhile, Medicare home visits have dropped 17% since 2017.

Healthcare Cybersecurity 52

Healthcare Cybersecurity Healthcare IT Mental health Medicare 52

Healthcare IT Today

MARCH 5, 2024

Rucker points out that the current data exchange standard in health care, the Trusted Exchange Framework and Common Agreement (TEFCA) , is “anchored on 1990s document exchange” and is useful for slow-moving bureaucratic decisions, not providing continuous access to data for improved health care.

FHIR 124

FHIR Interoperability Healthcare IT Medicare 124

Aging in Place Technology Watch

APRIL 2, 2020

But since doctors are now being reimbursed as though the visit was in person, that has been clarified to enable Medicare reimbursement for telehealth during the ’30 day’ plan of care. And that does not seem to have any change in tech use, though it may just not be documented. Comments to the contrary are welcome.

Telehealth 141

Telehealth Remote care mHealth Nursing 141

FierceHealthIT

JULY 12, 2018

CMS issued a proposed rule yesterday that makes what officials called “historic changes” to the Medicare program, including changes to E&M documentation requirements, new telehealth reimbursement opportunities and changes to the MIPS program.

Medicare 80

Medicare Telehealth 80

Electronic Health Reporter

APRIL 2, 2019

1, 2019, the Centers for Medicare […]. Beginning Oct. The article AHIMA and AHCA Partner To Train Skilled Nursing Facilities In Coding Ahead of Upcoming Reimbursement Overhaul appeared first on electronichealthreporter.com.

Nursing 89

Nursing Health Information Medicare 89

Telebehavioral Health Institute

JANUARY 12, 2023

In January 2023, the Centers for Medicare & Medicaid Services (CMS) rolled out a new telehealth “indicator” to make information about Medicare telehealth providers on publically-available clinician profile pages more readily available. Medicare Telemedicine Snapshot Data File. 2021 (2021). 2021 (2021).

Medicare 52

Medicare Telehealth Telemedicine Public Health 52

Healthcare IT News - Telehealth

MARCH 2, 2021

Mahoney said the restrictions inadvertently create a "donut hole" for Medicare Fee for Service patients, allowing the health system to offer care to everyone but them.

Telehealth 218

Telehealth Telemedicine Primary Care Health Policy 218