Relias

JULY 23, 2025

Documentation Documentation integrity involves the accuracy of the complete health record. Incomplete, inaccurate, or inconsistent medical record documentation increases the risk of medical errors and legal liability. drugs, supplies, or health care services for Medicare or Medicaid patients).

Best Practices

Nurse Practitioners in Business

JULY 24, 2025

Specific organizations and individuals, referred to as “Covered Entities,” are subject to the Privacy Rules and include healthcare providers, health plans, healthcare clearing houses, and business associates. Here are some things to avoid, regardless of how busy it gets or how stressed you and your staff feel.

HIPAA

American Nurse

JULY 9, 2025

Legal and professional considerations CFCNs who want to start their own clinic or business should evaluate which setting and reimbursement platform to pursue. Although nurses should check their state nurse practice act prior to developing their business structure, foot care remains one of the few areas that allows RN self-employment.

Medicare

Nurse Practitioners in Business

JULY 13, 2023

It’s an ongoing debate… Some view business planning as essential, whereas others think it’s optional. And some situations may or may not require a business plan. For example: Small, low-risk startups where the business owner has lots of experience or has started a business before.

Business

Nurse Practitioners in Business

JULY 5, 2023

In general, audits in business and healthcare are not uncommon. Now here’s what’s important about audits… They are not just for business owners. So basically…are you doing everything you should be doing, not only in the types of care you are providing but also in the business aspect of your practice? Would you rather listen?

Business

Nurse Practitioners in Business

FEBRUARY 24, 2024

Mistakes can happen at any point and across all aspects of building the business. While it is a personal and perhaps a business decision, consider the following. The most significant growth in those needing healthcare is the geriatric population, and most of them will have Medicare and seek providers accepting Medicare. (By

Medicare

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. It’s an unfair business practice.”

Retirement

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. It’s an unfair business practice.”

Retirement

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. However, they do not align with accepted medical or business practices. Unlike fraud, waste is not necessarily intentional but results from inefficiencies.

Medicaid

American Medical Compliance

MARCH 15, 2024

Furthermore, it prohibits knowingly submitting false or false claims to Medicare, Medicaid, or other federally funded healthcare programs. HIPAA regulations govern the use, disclosure, and safeguarding of protected health information (PHI) by covered entities and their business associates.

HIPAA

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.

Telemedicine

Capitol Beat

JANUARY 4, 2024

Not surprisingly, the main focus of advocacy is the federal Department of Health and Human Services (HHS) and its subagency, the Centers for Medicare and Medicaid Services (CMS). CMS is strengthening the Medicare Diabetes Prevention Program (MDPP) , which ANA supports.

APRN

Relias

NOVEMBER 4, 2021

A team of competent, compassionate, and qualified clinicians forms the backbone of every profitable home health business. Keeping an eye on your case mix is important with Medicare reimbursement shifting to value-based purchasing. Capturing the higher Medicare reimbursement potential that PDGM provides for those conditions.

Medicare

Relias

APRIL 18, 2022

Your business model revolves around competent clinicians, care quality, and reimbursements. When you invest in educating clinicians as wound care specialists, you can put your organization in a stronger business position by: Developing a team with clinical expertise in wound and ostomy care. Build Your Reputation as a Specialist.

Education

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

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

Celayix

FEBRUARY 7, 2023

This can also lead to decreased business and reduced revenue. This is a huge issue for both patients, and business owners in home healthcare. There is also the patient family, and the patient insurance provider, or the government in the case of Medicare or Medicaid. One of the most common issues is late or missed home visits.

Home Healthcare

Relias

OCTOBER 28, 2022

The Centers for Medicare and Medicaid Services (CMS) is ramping up survey scrutiny for hospice this year, training surveyors to focus on interdisciplinary group care planning and coordination of care as part of an emphasis on meeting four core Conditions of Participation. Documentation in the medical record.

Care coordination

Daily Nurse

SEPTEMBER 12, 2023

So, whatever we do, we document it and get reimbursed. Healthcare is a business, and every business has to show a return on investment. You’ll get better reimbursement from Medicare, the big blues, and everybody else in insurance. healthcare sector and what we can do to overcome these issues? What is their output?

Nurse Shortage

Healthcare Law Insights blog

NOVEMBER 10, 2023

The OIG suggests that understanding how funds flow through business arrangements and the varying incentives created by different types of funding structures is one of the best ways to identify fraud and abuse risks and is key to unearthing potential compliance issues, implementing effective monitoring, and identifying preventive strategies.

Leadership

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

American Nurse

APRIL 2, 2024

School and business closures exacerbated food insecurity and income inequality. Waite called on nurses to remember that social justice is a core tenet of ANA foundational documents, including the Code and Scope and Standards of Practice. Henderson noted that the healthcare payment structure doesn’t encourage focus on SDOH.

Health Insurance

American Nurse

JUNE 13, 2024

Certainly, the concept of advocacy is imbedded in the foundational documents of our profession. One example is local ordinance such as zoning law that prohibits certain kinds of businesses within a designated distance from a school. Examples include Medicare and the Patient Protection and Affordable Care Act of 2010.

Promotion

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. That would be terrible for your reputation and would hurt your business. Audit coding and billing to ensure clinical documentation integrity.

Medicaid

Scrubs

JUNE 21, 2023

22, three FDA inspectors arrived at the sprawling Intas Pharmaceuticals plant south of Ahmedabad, India, and found hundreds of trash bags full of shredded documents tossed into a garbage truck. Some are going out of business. Original Reporting by: Arthur Allen On Nov. Sardella and others have proposed government subsidies to get U.S.

Pharmaceutical

Relias

NOVEMBER 16, 2022

In April, the Centers for Medicare and Medicaid Services proposed a $320 million decrease in Medicare payments to skilled nursing facilities for fiscal year 2023. A study published in Value in Health on the cost of chronic wound care for Medicare beneficiaries revealed that nearly 15% of the patients (8.2 billion to $96.8

Education

Relias

FEBRUARY 1, 2023

Some Medicare Advantage plans are denying authorization for hospitalization. This is happening even though clinical documentation supports medical necessity and the stay meets the ’2-midnight’ rule per CMS guidelines ,” said Jennifer Ward, CRCS, denial specialist supervisor for patient financial services revenue integrity at Sharp HealthCare.

Physician Office