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How to Streamline Your Medical Claims Management Process for Better Results 

CollaborateMD

Challenges of Healthcare Claims Processing A medical claim is a request made by a healthcare provider to insurance companies (payer) to receive reimbursement for services rendered. Final Thoughts Streamlining your medical claims management process is not a one-time task but an ongoing practice of refinement and innovation.

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Medical billing audits: A proactive approach to compliance and revenue protection 

Health Prime

Also, document all the services provided and code them appropriately. Coding Validation: Determine if the medical code designated is correctly representative of services rendered according to the coding guidelines. Check for upcoding, unbundling, or misuse of codes.

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June 2025 Healthcare Data Breach Report

The HIPAA Journal

In June, HIPAA-regulated entities notified the HHS’ Office for Civil Rights (OCR) about 70 data breaches impacting 500 or more individuals, which is well above the 12-month average of 59 large data breaches per month. Geographical Distribution of Healthcare Data Breaches HIPAA-regulated entities in 29 states reported data breaches in June.

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RAG in Healthcare: Your Complete Guide to Its Implementation

Arkenea

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.

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Simplifying Compliance: How Medical Billing Services Keep You Audit-Ready

CollaborateMD

Some of the key components of medical billing compliance include: Understanding and following medical billing regulations like HIPAA , Medicare guidelines , and the latest ICD-10 compliance requirements. Ensuring accurate coding to avoid overbilling (upcoding) or underbilling (downcoding) patients. The result?

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2025 Guide to Billing in Hospital Management Systems

Arkenea

Security in cloud environments has evolved to meet healthcare requirements, with major providers offering HIPAA-compliant infrastructure and advanced encryption capabilities. These components must support ICD-10, CPT, and HCPCS coding systems while applying complex billing rules and fee schedules.

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Medical Billing Audits: A Proactive Approach to Compliance and Revenue Protection 

Health Prime

Also, document all the services provided and code them appropriately. Coding Validation: Determine if the medical code designated is correctly representative of services rendered according to the coding guidelines. Check for upcoding, unbundling, or misuse of codes.

Billing 52