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Health is an important asset to human beings. Patients, physicians, medical billing companies, insurance companies, clearinghouses, all are connected in one way or another to offer quality services. Physicians are then reimbursed for their services and that's how the process flows.

Health is an important asset to human beings. Patients, physicians, medical billing companies, insurance companies, clearinghouses, all are connected in one way or another to offer quality services. Physicians are then reimbursed for their services and that's how the process flows.

Health is an important asset to human beings. Patients, physicians, medical billing companies, insurance companies, clearinghouses, all are connected in one way or another to offer quality services. Physicians are then reimbursed for their services and that's how the process flows.

Reportedly, physicians are struggling with ethical concerns amidst the coronavirus pandemic. Johns Hopkins Hospital and Berman Institute of Bioethics in Baltimore has launched a moral round program where physicians find a solution to their problems by interacting with other colleagues and learn to deal with the COVID situation.

Overview: Learn how to improve your healthcare compliance program by using requirements found in corporate integrity agreements (CIAs) issued by the OIG. By proactively incorporating various features of CIAs, healthcare providers of all types can be better assured of meeting compliance standards. While there are many different types of healthcare compliance issues, probably the area of most concern is that of properly filing claims and receiving appropriate reimbursement. The OIG has issued various types of guidance including Federal Register entries, fraud alerts, and issues as listed in the OIG Work Plans. By providing such guidance, the OIG has given healthcare providers notice so that there can be no defense of not knowing about an issue. By organizing your compliance program to detect and then correcting various types of issues is a major objective of having a compliance program. Understanding systematic processes for improving your healthcare compliance program using CIA requirements can forestall possible criminal and civil monetary penalties. The hundreds of CIAs that have been developed when the OIG detects fraudulent activities can be used as a guide for developing and improving healthcare compliance programs for all types of healthcare providers. The process of statistical extrapolation is used by the OIG when conducting studies in order to determine recoupment amounts. Statistical extrapolation can also be used by healthcare providers when determining possible overpayments. However, the proper use of statistical extrapolation is a formal and complex mathematical process that must be properly applied. The OIG CIAs provide another resource for healthcare providers to study, understand, and then apply as appropriate. Why should you Attend: What are the OIG Corporate Integrity Agreements (CIAs)? Why does the OIG issue CIAs? Can I use general requirements from CIA to avoid monetary penalties or even avoid going to jail? Can any healthcare provider use

In this session Mr. Wolfe will provide an overview of the Stark Law and its 2016 changes. He will also discuss best practices for implementing and auditing physician compensation arrangements to minimize liability exposure and penalties, including conducting compliance audits, instituting policies, and establishing ongoing monitoring and review processes.

HIPAA Privacy Myths: HIPAA, the most comprehensive and as of now, the only truly Pan-American federal statute on health information, is unfortunately, still a target of misconceptions and myths. In particular, the Privacy Rule, which is the cornerstone of HIPAA's rule on confidentiality of patient information, offers room for many misconceptions. A few common HIPAA Privacy Myths: HIPAA Privacy Myths regarding communication between the patient and physician A common HIPAA Privacy Myth relates to the communication of mails between the patient and the physician. It is a common misconception that since the Privacy Rule is about ensuring the patient's privacy; it disallows email communication between the doctor and the patient. HIPAA Privacy Rule does allow this form of communication, so that the requisite safeguards are built into the communication aimed at ensuring the confidentiality and integrity of the mails. Transmission of the patient's protected health information Another of the common HIPAA Privacy Myths pertains to the transmission of patient information from one healthcare facility to another. Fact is, no permission is required for Covered Entities to disclose patient information from one clinic to another. The Covered Entity can also share Protected Health Information about the patient for legitimate purposes without the patient's consent or knowledge. Cumbersome and expensive HIPAA Privacy Rule regulations Many people tend to believe that the HIPAA Privacy Rule is a tangled web of regulations that are so complex and painstaking in terms of the administrative detail that implementation of the HIPAA Privacy Rule on a national scale is going to burn a hole in the national exchequer. This is completely untrue. On the contrary, over the years, implementation of the HIPAA Privacy Rule has been bringing down the administrative costs quite significantly, resulting in saving of a few billion dollars in the long run on administrative tasks like transactions

Overview: Joint Commission standards set a high bar for hospital medical staff bylaws. Since the 2011 changes to MS 01.01.01, bylaws must meet 37 elements of performance including hearing provisions, credentialing requirements, department director duties and more. But don't stop there-additional requirements are scattered through other Joint Commission standards. Each standard, element of performance and their quirks will be addressed and means of compliance explored. Why should you Attend: Joint Commission accreditation, sought by the overwhelming majority of American hospitals, hinges upon compliance with the Standards and their Elements of Performance set forth in the Joint Commission Accreditation Manual for Hospitals. Some of the most complex, detailed standards involve medical staff bylaws provisions and processes. Federal legal requirements change frequently in ways that unexpectedly affect these Joint Commission standards. This webinar addresses the most up -to-date Joint Commission requirements and industry best practices for medical staff bylaws compliance. Areas Covered in the Session: Joint Commission Standards for Hospitals Medical Staff Bylaws Hospital accreditation requirements Who Will Benefit: Medical Staff President Bylaws Committee Chair Chief Medical Officer Vice President of Medical Affairs Chief of Staff Director of Medical Staff Medical Staff Attorney Hospital Counsel Medical Staff Manager Speaker Profile Elizabeth A. Snelson represents medical staffs across the country, focusing on medical staff bylaws, and works for medical societies on medical staff issues. A frequent speaker on medical staff legal issues, Ms Snelson presents at medical staff leadership retreats, and in programs sponsored by state medical staff services associations and medical societies, the American Medical Association, the American Bar Association, and other organizations. She is Past President of the American Society of Medical Association Counsel, Vice Presi

Overview: This webinar provides an overview of the MACRA legislation and developing regulations and guidelines. We'll help you understand how medical practices will be paid in the future for services to Medicare patients. You'll be asked to choose between two paths. If you choose to participate with other providers in an Advanced Payment Model, the larger organization will be paid for services provided and determine how to share those payments as well as any cost savings among the participants. If you choose the Merit-Based Incentive Payment System (MIPS), your payment rate will vary based on how you perform on a variety of Medicare Quality Programs - PQRS, VBM, Meaningful Use and a 4th new component focused on Quality Improvement. You'll want to know as much as possible about the pros and cons of each option and how to make the right choice for your practice. Why should you Attend: Under the MACRA legislation, your providers will need to choose between participating in an Advanced Payment Model (APM) or participating in the new Merit-Based Incentive Payment System. Making the wrong choice can result in significant reductions in your future Medicare payments. You'll want to understand the options and have a plan in place by January 1, 2017 - that's only 6 months away. Areas Covered in the Session: Learn the requirements of the new MACRA legislation and how it will impact your Medicare payments in 2019 and beyond Find out what you need to be doing now to ensure you don't lose Medicare revenue in future years Understand the options - APM vs MIPS - and how your Medicare payments can increase or decrease under each model Identify what aspects of the new payment methodology are written into the legislation, what has been released through proposed regulations and when final rules are expected. Who Will Benefit: Practice Administrators, CEOs, COOs Physicians and all providers who bill to Medicare Quality Officers Nurse leaders Finance Directors Speaker Pro

Incidental disclosures form the crux of HIPAA compliance and patient care. HIPAA has elaborate rules on how to maintain these and in what situations. Health Insurance Portability and Accountability Act (HIPAA), a landmark set of federal regulations, is aimed at protecting patient privacy regulations. Yet, it is understood that some information has to necessarily be shared. HIPAA compliance and patient care is centered on the inevitable disclosures that have to be made, or what are called incidental disclosures. Initially, there was some ambiguity about incidental disclosures, resulting in some kind of haziness about HIPAA compliance and patient care. With these cleared, much of HIPAA compliance and patient care hinges on this principle. Incidental disclosures determine patient care compliance with HIPAA Incidental disclosures are what are termed secondary use, i.e., it is the unavoidable or inevitable disclosure of Protected Health Information. It is understood that incidental disclosures, being a byproduct of the course or nature of the treatment; are inescapable, given the condition and situation of the patient. Guiding factors for HIPAA compliance with patient care The aim of HIPAA's Privacy Rule is to ensure that healthcare providers have to use professional judgment guided by ethical guidelines at the time of making incidental disclosures. The following bases were propounded for adherence with HIPAA compliance and patient care: Whenever there is an unavoidable breach in confidentiality, the breach should be proportionate to the potential benefit the patient's gets from care When a patient is not present in the healthcare setting or is incapacitated, information about the patient can be shared with the family, friends or whoever else is involved in the patient's care. This protocol need not be documented. In relation to the above, a requirement of HIPAA compliance for patient care is that when the patient has a condition that is not related to the present tr

Healthcare fraud and abuse: Healthcare fraud and abuse are different but related kinds of malpractice. They affect everyone concerned: the patient, the healthcare unit, the healthcare sector, and eventually, the economy. Healthcare fraud and abuse are serious malpractices that can have very grave consequences for the patient, the hospital and the healthcare sector. They can also cost taxpayers heavy amounts of money. Healthcare fraud: There is some distinction between healthcare fraud and healthcare abuse. Healthcare fraud is said to happen, according to medicare.gov, when Medicare gets billed for a service or supply the end user never gets. These fraudulent claims result in loss of billions of dollars of revenue to Medicare each year. Healthcare fraud could be said to happen when: False statements are submitted knowingly or facts are misrepresented with the purpose of obtaining a federal health care payment for claims for which the person is not entitled A person knowingly solicits, pays, or/and accepts a payment with the intention of inducing or rewarding referrals for services or items that any of the federal healthcare programs reimburse Eligibility is falsified Prohibited referrals are made for select, designated health services Healthcare abuse: Although related, healthcare fraud and abuse are not totally similar to each other in spirit. A healthcare abuse can be when physicians do not comply with or bypass established good medical practices or administer treatments that are not necessary. This is less serious than fraud in terms of intent, but carries the same consequences: loss of billions of dollars to the exchequer and potential damage the patient's health and the physician's and/or healthcare provider's reputation. Some examples of healthcare abuse These are some of the examples of healthcare abuse: When services that are not medically warranted are performed and charged for When services and/or supplies are charged in excess of their actual value

A Hospital Incident Command System is a wonderfully effective system for handing disasters and emergency situations: A Hospital Incident Command System is an absolute must for hospitals when they have to carry out unforeseen emergencies. Having a process-oriented Hospital Incident Command System is an effective tool for dealing with situations and saving lives. A Hospital Incident Command System (HICS) is a standardized process that helps hospitals deal with emergencies, natural or manmade. HICS is common across hospitals in the US and have common terminology and organizational structure. It is a single system that all hospitals have to use. Since emergencies can happen at any time and can be of any gravity; it is imperative for physicians to have a command of how to deal with emergencies by understanding the Hospital Incident Command System and its role in disaster situations. HICS goes beyond patient care. Physicians and other staff need to both have access to disaster-specific and related information to the Hospital Incident Command System, as well as know how to handle it, in order to bring about an effective response and augment an existing one. Advantage of having a Hospital Incident Command System The biggest advantage of having a Hospital Incident Command System is that its practices and processes are similar to those used by external agencies in times of emergency. This makes sharing incident command systems that much more effective and easier to coordinate, and facilitates information flow. Features of a Hospital Incident Command System A Hospital Incident Command System provides a flexible reporting structure with defined roles and responsibilities It sets up and facilitates communication flow and documentation protocol It provides the hospital operations a concrete strategic direction-oriented support by leveraging and optimizing additional resources such as staff and equipment, so that these are used where they are needed the most. A Hospital Incident

Mexico is close by, doctors are well trained, the cost is reasonable, and there is virtually no waiting list, but, how do you find a physician in Mexico?

Overview: Today's diverse, fast-changing, multidisciplinary mental health care environment involves many mental health care professionals who work together for the common goal of the patient. This includes physicians/psychiatrists, psychiatric nurses, psychologists, and others. Nothing in health care is more fractured than in mental health among a multitude of mental health practitioners. Like physicians/psychiatrists and psychiatric nurses, psychologists as health care practitioners obtained an education, passed applicable examinations, completed professional training, and hold a license to practice their chosen profession of psychology, often by being educated and trained at the doctoral level. The license to practice is issued by the state agency which has exclusive jurisdiction over this health care practitioner. Thereafter, the state's authority and power over the psychologist often presents challenges to that professional that are not easy to navigate. Their governing state agency routinely handles, investigates, and dismisses- or prosecutes - alleged violations of law that can be career ending for the psychologist if pursued. But that process takes time with many steps necessary for due process of law. One of the ultimate actions the state may take is to issue a suspension or revocation of the psychologist's professional license. Yet many state actions fall short of such drastic outcomes, but still have serious, permanent consequences for the psychologist as a licensed health care professional. Learn to identify the legal authority for state agencies to regulate the practice of psychology. Seek to understand and defend against state actions which may result in ruinous practice and career consequences for the health care professional. This program offers an objective, thorough review of the ethical and legal violations committed by psychologists. This program also reviews defenses with practice tips to defend successfully those common violations. Otherwis

The research advancement in diagnosis and treatment procedures of cardiac ailments has meant a higher degree of vigilance for physicians. Having to cope with advancement of cardiac care standards, physicians rarely find time and resources that can manage billing and coding of their services.

Our medical billers and coders stationed in New Jersey, provide physicians with the latest in reimbursement strategies and government updates in terms of the healthcare industry. Their presence across all major cities such as Newark, Jersey City, Patterson, Elizabeth and Edison offer Physicians options to locate well trained Medical Billers and coders easily.

The research advancement in diagnosis and treatment procedures of cardiac ailments has meant a higher degree of vigilance for physicians. Having to cope with advancement of cardiac care standards, physicians rarely find time and resources that can manage billing and coding of their services.

Physicians Revenue Group Inc. offers revenue cycle management services in Houston. We help medical practices with effective claim submission approach to ensure fast reimbursements. Our revenue cycle management services in Houston help you to optimize revenue cycle process to achieve financial stability.