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How to Conduct Effective Compliance Audits 

American Medical Compliance

The healthcare industry is highly regulated, with various laws such as the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH), and the Medicare and Medicaid Services (CMS) regulations shaping operations.

HIPAA 105
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Navigating New CMS Skin Substitute Updates: Essential Policies for Wound Care Providers

Relias

million Medicare beneficiaries in the U.S. Using non-covered products or failing to meet documentation standards can lead to reimbursement denials, audits, and delayed or disrupted care for vulnerable patients. Wound care providers are entering a new compliance landscape, which will impact 10.5 with chronic wounds. Heres how: 1.

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Home Health Referrals: Grow Your Network

Relias

For Medicare claims, you already track care quality and report it to the Centers for Medicare and Medicaid Services (CMS). Those quality ratings appear on Medicare’s Care Compare website and inform prospective clients how well you’re achieving positive outcomes. Improve Your Quality Ratings.

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Home Health Specializations Boost Performance, Bottom Line

Relias

Successful agencies recognize that long-term success depends on meeting required clinical regulations and having staff with the home health specializations to meet shifting client needs. Keeping an eye on your case mix is important with Medicare reimbursement shifting to value-based purchasing. Increasing agency profitability.

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How to Create a Ketamine Compliance Program

Relias

Establish oversight and documentation protocols Spravato has a built-in reporting system that notifies providers and organizations when a dose is missed. Accurate documentation of all dosing decisions and adjustments is critical, as it supports treatment planning, insurance approvals, and compliance with regulatory standards.

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12 Days of Compliance Countdown

Relias

Tis the season for evaluating training programs and checking everything twice to make sure you’re on the Center for Medicare and Medicaid Services’ and The Joint Commission’s nice lists. The video training you have isn’t up to date anymore. Consider your organization–assigned document or individual staff member?

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Is Your Practice Ready for Growth?

Nurse Practitioners in Business

New services often require new protocols and staff training. Would you need to hire additional staff? Improve Coding Accuracy and Documentation If your billing is in-house, you can boost revenue by ensuring that coding accurately reflects the complexity of care you provide.