If you’re a healthcare provider or facility dealing with Medicare, one thing is certain – getting properly reimbursed is a maze filled with complex rules, convoluted paperwork, and often, sheer frustration. Medicare reimbursement is the lifeblood that keeps many healthcare operations afloat, but navigating its serpentine pathways can feel like a daily battle. Buckle up […]
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Posts tagged "medicare"
Brace for Impact: Managing the Surge of New Medical Billing Regulations
As US healthcare costs continue rising steeply – now over $4 trillion representing nearly 20% of GDP – both federal and state policymakers urgently seek ways to contain runaway expenditure growth. This drive manifests through expansion of programs like Medicare Advantage and Medicaid managed care coupled with accelerating passage of game-changing legislation like No Surprises […]
billing, Billing Best Practice, Billing Disruption, billing revenue, Claim Data, Consumer-Centered Billing, Good Faith Estimates, Health Level 7, healthcare, HL7, Interoperability, medicaid, Medical Billing Regulations, medicare, No Surprises Act, Pre-AuthorizationDetecting and Preventing Healthcare Fraud and Abuse: A Comprehensive Guide
At Medwave, we are dedicated to providing valuable insights and guidance on detecting and preventing healthcare fraud and abuse. In this comprehensive article, we will equip you with the knowledge and tools necessary to safeguard your organization and patients from these malicious activities. By implementing the strategies outlined below, you can enhance the integrity of […]
fraud, healthcare, Healthcare Abuse, Healthcare Fraud, medicaid, medicaid fraud, Medical, Medical Fraud, medicare, medicare fraud, Phantom billingMedical Credentialing: The Importance of Proper Verification and Accreditation
Proper Verification and Accreditation in Medical Credentialing The process of medical credentialing is crucial in ensuring the quality and safety of healthcare services. It involves verifying the credentials and qualifications of healthcare providers and evaluating their competency to provide medical services. In this article, we will delve into the importance of proper medical credentialing and […]
accreditation, Credentialing, education verification, healthcare credentialing, medicaid, medical credentialing, medicare, verificationMedicare and Medicaid Fraud: A Growing Problem in the Healthcare Industry
Medicare and Medicaid Fraud is a Massive Healthcare Industry Problem Medicare and Medicaid Fraud Vulnerability The Medicare and Medicaid programs provide crucial support to millions of Americans, offering access to healthcare services for those who may not otherwise be able to afford it. Unfortunately, these programs are also vulnerable to fraud, with criminals exploiting the […]
Billing for services not rendered, billing fraud, False certification, fraud, Kickbacks, medicaid, medicaid fraud, medical billing fraud, medicare, medicare fraud, Phantom billing, Prescription drug fraud, Supply fraud, Unlawful self-referral, Upcoding, Whistleblower, Whistleblower Protection ActPayer Contracting, What Healthcare Providers Should Understand
Let’s begin with this set-up: Let’s say you’re hunting for a new job and receive a call from a would-be employer informing you that the job is yours. Of course, you’re thrilled by the news and inquire about your starting salary. Your new employer replies that you need to wait for your first paycheck to […]
Credentialing, healthcare credentialing, medicaid, medicare, private insurers, Provider Credentialing, provider networks, reimbursement ratesDoes Medicare Cover (Mental Health Services) such as Therapy?
Are Mental Health Services (like Therapy) Covered Under Medicare? Behavioral / Mental Health Services + Medicare Sometimes it can be problematic for older adults to differentiate indicators of mental health difficulties for typical aging-related changes. They may think that experiencing sadness or anxiety is an ordinary symptom of growing older, particularly when they live with […]
Behavioral Health, Behavioral Health Billing, medicaid, medicare, medicare coverage, Medicare Therapy, Mental Health, Mental Health BillingWhat Does Medicare Cover for Home Healthcare?
Home Health Services + Medicare What does Medicare Cover for Home Healthcare? If you’re looking for an answer to the question, “What does Medicare cover for home healthcare?”, you’ve probably typed it into a search engine and immediately closed the tab. The amount of information and the level of detail can quickly become confusing and […]
healthcare, healthcare services, home health care, home health services, home healthcare, medicaid, medicaid billing, medicaid coverage, medicare, medicare billing, medicare coverageCommon Examples of Medicare, Medicaid Fraud
Medicare, Medicaid Fraud Examples and Steps to Ensure You Don’t Commit It A medical doctor invoiced his patient’s Medicare insurance for both the services he actually delivered and for services that were not delivered. He fabricated his patient’s medical records to indicate office visits and treatments that never took place. A gerontologist obtained the outcomes […]
billing fraud, false claims act, fraud, medicaid, medicaid billing, medicaid fraud, medical billing fraud, medicare, medicare billing, medicare fraud, Upcoding4 (Medical Billing) Techniques that Can Assist Your Practice
Medical Billing Techniques that Can Be Installed to Help Your Medical Practice Health care providers should periodically review their financials and revenue cycle, so that they can take corrective measures at the earliest if required. A great deal of medical offices / health care providers find that medical billing is one area which could be […]
AI, Automation, EHR, medicaid, Medical Billing, medicare, MIPS, Outsource Medical billing, Pittsburgh Medical BillingIn 2018, (New Medicare Cards) are Coming
New Medicare Cards are set to arrive in 2018 Due to the rising issues of identity theft in the country, the Social Security Administration fears that the current Medicare cards labeled with beneficiaries social security numbers are a high risk. A bill signed in 2015, by President Obama gives the Department of Health and Human […]
2018 Medicare, 2018 Medicare Cards, Cranberry Medical Billing, MBI, Medical Billing, medicare, medicare beneficiary indentifier, medicare cards, new MBI, new medicare cards, Pittsburgh Medical Billing, social security administration, social security number removal initiative, SSNRI