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Billing often becomes one of the biggest administrative burdens for solo and small behavioral health practices. Reliable billing support can help reduce that administrative workload, stabilize cash flow, and let providers devote their energy to what matters most: patient care.
Medical billing audits are a great tool for achieving compliance and safeguarding revenue. Also, third-party payers conduct billing audits through their employees or their agents. Fraud Avoidance: Either billing errors or fraudulent activities committed on your part can lead to criminal prosecution and a tainted public image.
Not if you ask billing managers. The truth is that the road conventional health insurance follows in processing claims is needlessly complicated, leaving room for many unwanted errors and frustrated providers. Healthcare providers and organizations have the power to improve medical billing and collections. Easy, right?
Verisource Services, an employee benefits administration service provider, has determined that a previously announced data breach was far worse than initially thought and has affected up to 4 million individuals.The Houston, Texas-based company detected a hacking incident on February 28, 2024, that disrupted access to some of its systems.
These are likely to continue to be reported by affected HIPAA-regulated entities over the next few weeks. CA Health Plan 12,224 Unauthorized Access/Disclosure Mailing incident involving mailing vendor (Billing Documents Specialists) Shipping labels contained Social Security numbers.
Healthcare practices are often plagued with medical billing compliance questions like: “Am I upcoding?” ” With all of these concerns, it’s vital that providers and billing departments understand and follow the key elements of proper medical billing compliance to run a successful practice.
Medical billing audits are a great tool for achieving compliance and safeguarding revenue. Also, third-party payers conduct billing audits through their employees or their agents. Audits can reveal missed revenue opportunities, coding errors, and underpayments by examining billing processes and claims to maximize potential revenues.
Manual methods are prone to: Human Error : Misfiled billing codes, missing data, and inaccuracies are common with manual input, according to one report. Enhancing Accuracy and Reducing Human Dependence Medical claims include billing and diagnostic codes that must be accurate for claims to be processed efficiently.
Here, we offer insight into the medical ethics to follow while working in a medical assistant career. The AAMA has both a creed and code of ethics that medical assistants should follow: The American Association of Medical Assistants Creed The creed outlines the mindset medical assistants should have as they perform their work.
While talking up strengths is important, so is acknowledging weaknesses. They’ll also want a candidate to elaborate on any experience filling out forms, reviewing medical records, or performing billing and bookkeeping services. They want to see if a candidate is capable of self-reflection and is actively seeking professional growth.
But what exactly is RAG in healthcare, and more importantly, how can your organization implement it successfully while maintaining HIPAA compliance and ensuring patient safety? Compliance Challenges : Many AI solutions weren’t designed with HIPAA requirements in mind, creating potential compliance risks.
” You’ll also be handling “ follow-up ” visits, repeat visits just to check how someone’s doing. Another important word is “HIPAA.” Insurance and Billing You often talk to patients about their insurance when working at the front desk. That clearance is their referral.
Clarifying a patient’s misunderstanding of the HIPAA privacy rule Rachel V. Rose, JD, MBA June 19th 2025 Article Understanding HIPAA's Privacy Rule clarifies how incidental disclosures in health care settings are permissible, ensuring patient privacy while facilitating essential communications. Singer, M.D.,
EHR revenue cycle management represents far more than simply connecting clinical and billing systems. Essentially, EHR RCM signifies the integration of billing processes with clinical operations, leading to the improvement of financial performance while ensuring the delivery of optimal patient care.
It’s also crucial to maintain patient confidentiality and follow Health Insurance Portability and Accountability Act (HIPAA) regulations. They also may work with a patient to schedule any follow-up appointments. This can be done by having up-to-date documentation, such as a CPR certification.
When searching for AI solutions to integrate into your workflow, look for products that are built with the following in mind: Behavioral health vs. generic healthcare Facility type: inpatient vs. outpatient Client type: demographics, diagnosis, solo vs. group treatment, etc. Which tasks pile up and hang over your head?
Neil Baum, MD Successful practices do not follow others; rather, they make their own paths and follow their own pathways and agendas. Neil Baum, MD Successful practices do not follow others; rather, they make their own paths and follow their own pathways and agendas. Edison said, "I have not failed 10,000 times.
It can bring a refreshing shift from scattered patient files and billing information to seamless, stress-free workflows and revenue management. Billing and Claims Management : Ensure smooth processes for medical billing , insurance claims, and payment collection. Is the data backed up on a mirrored out-of-state site?
Medical practice software: the best of 2025 As a medical workflow company, our team at Mobius MD constantly follows the latest in practice management software and health IT. In fact, epocrates has delivered up-to-date research and clinical content to physicians around the globe since 1998.
This necessitates the acquisition of a permanent license, which frequently involves paying a hefty up-front cost. Additionally, in addition to the software requirements, hardware acquisition costs also pile up higher in case of on-premise EHRs as compared to cloud hosted EHR.
The HIPAA Journal reveals a report in which experts investigated 23,000 medical malpractice lawsuits and found that more than 7,000 were due to communication failures. Increase patient follow-up care. Help individual patients with their healthcare needs or billing questions. Those failures resulted in $1.7
HIPAA violation cases are compliance investigations that result from a data breach being notified to the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) or a privacy complaint being submitted to OCR via the complaints portal. There are many different types of HIPAA violation cases.
In today’s digital age, medical billing software plays a vital role in streamlining the billing process and improving patient care. HIPAA compliance is a crucial aspect of any medical billing software. It will also help you ensure that the medical billing software you select is compliant with HIPAA requirements.
Key Takeaways Healthcare developers must follow the three key HIPAA rules during API development: HIPAA security rule, privacy rule, and the breach notification rule. For example, providers may need API for automated appointment scheduling and bill payments to save their time and money.
Having a profound understanding of the HIPAA rules puts you one step ahead in the healthcare sector. HIPAA risk assessment ensures that ePHI is protected from threats and vulnerabilities such as fraud, data breaches, financial scams, identity thefts, etc. HIPAA Compliance Checklist 1.
Opting for the correct coding partner holds the key to: Accurate reimbursement Streamlined billing processes Overall operational efficiency Beyond financial considerations, choosing the right coding partner allows providers to redirect their focus towards core competencies , confident that medical coding is in the hands of specialists.
Medical billing plays a critical role in the financial stability of healthcare providers. Fortunately, medical billing software offers a solution to the challenges healthcare providers face. The impact of billing challenges is felt by healthcare providers and patients. They can have significant consequences for patients.
HIPAA compliance costs can greatly vary depending on the kind of application you’re developing. Developing a healthcare application that complies with the Health Insurance Portability and Accountability Act (HIPAA) is essential for safeguarding sensitive patient information and adhering to legal standards.
Medical billing audits are a great tool for achieving compliance and safeguarding revenue. Also, third-party payers conduct billing audits through their employees or their agents. Fraud Avoidance: Either billing errors or fraudulent activities committed on your part can lead to criminal prosecution and a tainted public image.
The cracks show quickly: choppy audio erodes patient confidence, unsecured links expose protected health information, and mismatched billing codes can leave thousands of dollars on the table. Tech upgrade success: 6 rules every practice should follow Keith A. 7 quick checkpoints for practices June 26, 2025 By Keith A.
Navigating piles of billing paperwork drains your time and energy. The right medical billing software streamlines this process, making it quicker and more accurate. This article breaks down chiropractic medical billing software. Then, we’ll show you how it helps keep your billing process moving along smoothly.
Are you considering partnering with an ophthalmology medical billing company for your facility? Outsourcing Your Medical Billing Can Free up Time and Resources for Your Ophthalmology Facility Those working in the ophthalmology industry often wear many hats while providing comprehensive care for their patients.
The HIPAA Journal has compiled healthcare data breach statistics from October 2009, when the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) started publishing summaries of healthcare data breaches on its website. This page is regularly updated to reflect the latest healthcare data breach statistics.
These days, billing can be complex. It makes billing simpler and more accurate. The medical billing market is growing fast. This growth shows just how vital medical billing is becoming. This growth shows just how vital medical billing is becoming. Medical billing software comes with many helpful features.
If you’ve ever considered a job in healthcare but don’t want to work directly with patients, medical billing and coding may be a good fit! Medical billing and coding professionals are aging out–as in retiring–and there aren’t enough qualified people to replace them. They’re used for billing and insurance reasons.
Syracuse, NY-based Practice Resources provides billing and other professional services to healthcare organizations. Class members may submit a claim for reimbursement of documented losses up to a maximum of $5,000 per class member. Million Data Breach Settlement appeared first on The HIPAA Journal.
The HIPAA Journal first reported a potential data breach in August 2024, after the RansomHub ransomware group added NeuroSav to its dark web data leak site. The post Georgia & Missouri Healthcare Providers Notify Patients About 2024 Hacking Incidents appeared first on The HIPAA Journal.
Regulatory Standards CERT (comprehensive error rate testing) is a program administered by the Centers for Medicare & Medicaid Services (CMS) that utilizes Recovery Audit Contractors (RACs) to review medical records and identify potential billing errors. The RACs are the ones conducting the audits. As researched by OS Inc., “If
” The quid pro quo value exchange is that GNC ramps up its membership list of consumers for the program and the promise of other purchases from the virtual or brick-and-mortar “front of the store.” GNC is channeling to the current concerns of health consumers… value in the eye of the beholder and medical bill payer.
Compliance with the Health Insurance Portability and Accountability Act ( HIPAA ) and other laws/regulations is mandatory. In addition, complying with HIPAA protects your patients, your practice, and helps you avoid fines and penalties. Your EHR software can help with HIPAA compliance. Your EHR software can help with this.
Following these standards helps prevent potential legal issues in the future. Legal Standards for a Medical Assistant to Follow As a medical assistant goes about their work, they must adhere to the Health Insurance Portability and Accountability Act (HIPAA) , which limits a healthcare provider’s ability to share patient information.
Those who have chosen medical coding and billing career paths are relied upon to help facilities manage patient visits and procedures. Those who work in medical coding will then take this information and connect these services to medical billing codes. What Is Medical Billing? Why Are Medical Coding and Billing So Important?
And keeping up with evolving audit requirements is essential, as regulations are updated or revised. Adhering to regulations—HIPAA is the most widely known—is one way to help ensure that confidentiality. A practice’s billing will need to align with all legal and regulatory requirements.
Data had been backed up, and the backups were unaffected, so data could be recovered, and the network was rebuilt and restored within a week. The post Gardner Orthopedics Ransomware Attack Affects 47,000 Patients appeared first on The HIPAA Journal. The company also rebuilt the affected systems and strengthened security.
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