The HIPAA Journal

JULY 11, 2025

A settlement has been approved to resolve a class action lawsuit against East Carolina Health (EC Health) that stemmed from a 2023 data breach that affected 19,085 individuals. The data breach occurred at East Carolina University’s Brody School of Medicine, a member of EC Health, and was discovered on or around December 21, 2023.

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HIPAA Insurance Diagnostics Documentation 72

The HIPAA Journal

JULY 22, 2025

Specialty Networks LLC, a Cardinal Health company that provides radiology information systems and PPS analytics to urology, gastroenterology, and rheumatology practices to improve patient outcomes, has agreed to settle a class action lawsuit stemming from a 2023 data breach.

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HIPAA Insurance Documentation Scheduling 49

The HIPAA Journal

JUNE 12, 2025

A settlement has been agreed to resolve class action data breach litigation against HealthEC and its clients over a 2023 hacking incident and data breach. Between July 14, 2023, and July 23, 2023, hackers accessed its network and stole files containing sensitive data. The settlement has received preliminary approval by Hon.

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HIPAA Follow-Up Documentation Insurance 62

The HIPAA Journal

JULY 11, 2025

The stolen information included names, Social Security numbers, taxpayer identification numbers, medical or health insurance information, and other sensitive information. The affected individuals were notified about the data breach on March 14, 2023. According to the lawsuit, approximately 3.9

Follow-Up 52

Follow-Up HIPAA Documentation Insurance 52

The HIPAA Journal

APRIL 1, 2025

On October 9, 2023, Azura Vascular Care identified suspicious network activity, with the forensic investigation confirming that hackers had access to its network between September 27, 2023, and October 9, 2023, during which time they potentially stole the protected health information of patients.

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HIPAA Documentation Billing Scheduling 62

Medical Economics

JULY 8, 2025

Industry data showed that insurers on HealthCare.gov denied about 19% of in-network claims in 2023 ; that’s $73 million out of $319 million in claims filed. For example, if you see a spike in denials from a particular insurer due to eligibility, you know exactly where to focus your front-end efforts.

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Huddles/Rounds Follow-Up Medication Patient Experience 66

Arkenea

JUNE 9, 2025

C-CDA C-CDA (Consolidated-Clinical Document Architecture) was created by HL7, ONC (Office of National Coordinator for Health Information Technology), HIE (Integrating the Healthcare Environment), and the Health Story Project. HL7 states that C-CDA provides a library of templates and prescribes their use for specific document types.

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Unit Organization and Environment Documentation Patient Satisfaction Certification 52

The HIPAA Journal

MARCH 19, 2025

An investigation was launched which revealed an unauthorized third party had access to the email account for 2 months since November 6, 2023, and other email accounts may also have been accessed. On January 14, 2025, an employee emailed a document to a personal email account.

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HIPAA Documentation Insurance Medication 75

The HIPAA Journal

MARCH 21, 2025

A New York woman has avoided a jail term for a criminal violation of the Health Insurance Portability and Accountability Act (HIPAA), having been sentenced to probation. On March 23, 2023, Tonya DAgostino, 53, of Farmington, New York, mailed a parcel via USPS Priority Mail to an individual in Medina, New York.

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HIPAA Documentation Insurance 49

Sensible Medicine

JULY 17, 2025

The Insurance Companies Knew First The medical profession's relationship with hypertension has an embarrassing history. It was insurance companies, not doctors, who first identified the dangers of high blood pressure. A follow-up study confirmed these extreme elevations, documenting pressures up to 345/245 mmHg during heavy lifts.

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Follow-Up Insurance Medication Documentation 307

Medical Economics

JUNE 9, 2025

Canceling services and coordinating mail forwarding are important tasks to prevent unnecessary expenses and ensure receipt of important documents. Financial advisor According to a 2023 Medical Economics survey , only about two-thirds of physicians who were looking to exit their businesses hired a financial advisor.

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Transfers Documentation Medication Follow-Up 52

Healthcare Dive - Practice Management

JULY 9, 2025

The FDA has been enthusiastic about continuous manufacturing, issuing initial guidance in 2020 meant to encourage manufacturers to harness similar technologies , before finalizing its guidance in 2023. This administration wants to do a lot, and they want to do it with not as many resources as have previously been used,” she said.

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Follow-Up Medical Coding Medication Billing 110

The Healthcare Blog

MARCH 18, 2025

A 2023 report by the Presidents Council of Advisors on Science and Technology declared patient safety an urgent national public health issue. To be effective, however, collaborative problem-solving on a large scale requires more than just setting up Zoom calls and sharing documents. All opinions are my own.)

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Patient Safety Collaboration Hospital Medication 67

Forbes Healthcare

JUNE 28, 2025

Home Warranty Cost Best Home Appliance Insurance Best Solar Companies Best Solar Panels Cost Of Solar Panels Solar Tax Credit By State Are Solar Panels Worth It? Follow Author Jun 28, 2025, 10:35am EDT Jun 28, 2025, 10:37am EDT Share Save Comment An egret flying from the lake in Anuradhapura, Sri Lanka, on September 23, 2023.

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Insurance Follow-Up Transfers Documentation 300

Forbes Healthcare

JUNE 19, 2025

Home Warranty Cost Best Home Appliance Insurance Best Solar Companies Best Solar Panels Cost Of Solar Panels Solar Tax Credit By State Are Solar Panels Worth It? According to data compiled by Grant Watch , a grassroots network of independent scientists documenting funding cuts, approximately $3.2

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Insurance Follow-Up Transfers Documentation 269

Health Populi

FEBRUARY 27, 2024

That’s the mantra coming out of this week’s annual Capitol Conference convened by the National Association of Benefits and Insurance Professionals (NABIP). FYI you might know of NABIP by its former acronym, NAHU, the National Association of Health Underwriters).

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Billing Insurance Hospital HIPAA 142

Health Prime

OCTOBER 10, 2024

According to The State of Mental Health in America 2023 , 21% of adults are currently experiencing a mental illness, which equates to over 50 million Americans. Mental health providers must ensure they use the correct diagnosis and procedure codes when submitting claims to insurance companies.

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Billing Medical Coding Documentation Appointments 97

The HIPAA Journal

JULY 9, 2024

SouthCoast Health and Privia Medical Group in Georgia have notified patients about a cyberattack and data breach that occurred in June 2023. During that time, files on the network were viewed or copied.

Triage 123

Triage HIPAA Documentation Billing 123

Arkenea

JULY 12, 2024

Medical insurance verification software is developed to automate the process of verifying patients’ insurance coverages. This software is connected to the insurance company’s database to retrieve real-time data on a patient’s insurance status. CDC reveals that 10.9 CDC also reveals that 3.9 In 2022, 92.1

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Insurance EHR / EMR Medication Patient Satisfaction 52

Minority Nurse

FEBRUARY 22, 2024

Financial Constraints and Budgetary Cuts Healthcare institutions often face financial constraints, with shrinking budgets and reduced reimbursements from insurance companies and government programs. link] Joint Commission (2023, August 24). link] Mcfanhn, C (2023, August 24). link] Muoio, D (2023, August 24).

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Patient Care Critical Thinking Hospital Patient Safety 111

The HIPAA Journal

MARCH 7, 2025

A further hacking incident was experienced in 2021 and was disclosed by Apria Healthcare in May 2023. Hackers had access to its network between August 27, 2021, and October 10, 2021, and potentially viewed or obtained personal, medical, health insurance, and financial information.

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HIPAA Documentation Insurance Medication 81

The HIPAA Journal

APRIL 4, 2025

Dameron Hospital Notifies Patients About November 2023 Data Breach Dameron Hospital in Stockton, California, has recently sent notification letters to patients about a November 2023 data breach. Notification letters were mailed to the affected individuals on February 21, 2025.

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Hospital Follow-Up HIPAA Insurance 69

ACMA Blog

JULY 9, 2024

FTC Conducts Investigation into PBMs Because PBM practices lack transparency and accountability to the public, in 2022, the Federal Trade Commission (FTC) requested data and documents of business practices to the six largest PBMs: Caremark Rx, LLC, Express Scripts, Inc., pharmacies in 2023. OptumRx, Inc., drug prescriptions.

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Insurance Patient Centered Care Medication Certification 98

Healthcare Law Insights blog

JULY 7, 2023

A handful of FCA circuit court decisions issued in 2023 are noteworthy as well. Importantly, although the court assumed the relator engaged in some protected activity, the court found that in many of her communications she, at most, characterized discrepancies in therapy documentation as mistakes or possible computer glitches, not fraud.

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Transfers Hospital Documentation Admissions 52

Valant

JULY 29, 2024

This code is acceptable to insurers when used to describe a marked change in mental health status not attributable to other factors. Check out the 2023 ICD-10 updates here. Altered mental status, unspecified (R41.82) is a billable ICD-10 diagnostic code under HIPAA regulations from October 1, 2020, to September 30, 2021.

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Diagnostics HIPAA Insurance Medication 97

The HIPAA Journal

MAY 23, 2025

Over the course of two weeks, the hackers exfiltrated sensitive data such as full names, Social Security numbers, dates of birth, contact information, provider information, billing information, insurance information, medical record numbers, diagnoses, and treatment information. More than 50 facility partners were affected by the breach.

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HIPAA Documentation Billing Insurance 83

The Healthcare Blog

APRIL 2, 2024

billion (or 60% of its total revenues) represent clinical and business services provided to United’s Health Insurance business. Source: 2023 UNH 10K For most of the past decade, Optum has been driving force of incremental profit growth for United. billion in 2023 (55% of total). in the third quarter of 2023.

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Tests Hospital Insurance Follow-Up 132

The HIPAA Journal

MAY 9, 2025

A settlement has received preliminary approval from a judge to resolve a class action complaint against Imagine360 over a 2023 hacking incident involving its Citrix file-sharing solution.Imagine360 is a Chesterbrook, Pennsylvania-based company that offers health plan administration and telemedicine services.

Transfers 57

Transfers HIPAA Insurance Documentation 57

The HIPAA Journal

MAY 22, 2025

Class members may submit a claim for reimbursement of documented monetary losses reasonably traceable to the data breach up to a maximum of $10,000 per class member.

HIPAA 52

HIPAA Insurance Documentation Scheduling 52

Health Prime

JUNE 22, 2023

According to a recent Precedence Research report , the gastroenterology market size 2023 is USD 54.56 Accurate gastroenterology coding and documentation Accurate coding and thorough documentation are the foundation of successful medical billing. billion, expected to grow to USD 93.8 Billion by 2032.

Best Practices 52

Best Practices Billing Medication Documentation 52

The Healthcare Blog

MARCH 13, 2024

Many patients must contend with well-documented side effects such as nausea, diarrhea or the significant loss of lean body mass (ie. muscle) and bone density. Again, those are lifetime side effects. and some patients simply tire of giving themselves a weekly injection.

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Documentation Insurance Patient Care Medication 96

Healthcare Law Insights blog

NOVEMBER 21, 2023

The good news for administrators is that they are permitted to submit affidavits or other documents from outside the administrative record that show that the conflict of interest played no role in the decision-making. A documented history of arbitrary claims denials by the administrator. Reliance Standard Life Insurance Co. ,

Documentation 52

Documentation Follow-Up Medication Insurance 52

ACMA Blog

JUNE 25, 2024

It is the insurance or payers’ way of controlling costs by approving or denying certain medications, procedures, or devices that may not usually be covered or is on a higher tier on the formulary. Clinical Documentation Specialist (CDS): A CDS can help in the PA process by accurately documenting patient records.

Medical Assistant 40

Medical Assistant Documentation Insurance Certification 40

ACMA Blog

OCTOBER 16, 2023

It is the insurance or payers’ way of controlling costs by approving or denying certain medications, procedures, or devices that may not usually be covered or is on a higher tier on the formulary. Clinical Documentation Specialist (CDS) : A CDS can help in the PA process by accurately documenting patient records.

Medical Assistant 40

Medical Assistant Documentation Certification Communication 40

Health Prime

JUNE 22, 2023

According to a recent Precedence Research report , the gastroenterology market size 2023 is USD 54.56 Accurate gastroenterology coding and documentation Accurate coding and thorough documentation are the foundation of successful medical billing. billion, expected to grow to USD 93.8 Billion by 2032.

Best Practices 40

Best Practices Billing Medication Documentation 40

Healthcare Law Insights blog

JANUARY 15, 2025

From 2018-2023, OCR observed a 102% increase in breaches affecting 500 or more individuals, with 167 million affected in 2023 alone. Attachments should be in Microsoft Word or Portable Document Format (PDF). On December 27, 2024, the U.S. population. [1] Follow the instructions at: [link] for submitting electronic comments.

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HIPAA Business Associate Follow-Up Documentation 52

Healthcare Law Insights blog

AUGUST 28, 2023

4] From court documents, it appears the government argued that Dr. Elfenbein knew that the patients whose insurance would be billed for E/M services would be with physicians “less than five minutes,” [5] and that Dr. Elfenbein told employees that E/M services were “the ‘bread and butter’ of how we get paid.” [6] 11, 2023). [4]

Billing 52

Billing Tests Documentation Medication 52