In April of 2019, the Centers for Medicare and Medicaid Services (CMS) announced it is rolling out a new set of CMS value-based payment goals. It’s called the CMS Primary…
Assisted Living Business – What are the Main Challenges?
There are significant challenges facing the assisted living business. The U.S. Census Bureau has projected that by 2030, the over 65 population will be at 74 million, and nearly one…
Healthcare Recruitment Strategies
Employees represent the foundation of every healthcare operation, and thus, effective healthcare recruitment strategies are a fundamental component of every successful operation. As a service-oriented industry, healthcare depends on the…
What Does HIPAA Compliance Mean?
What exactly is HIPAA, and what does HIPAA compliance mean? Healthcare providers and their business associates are aware of the importance of maintaining HIPAA compliance. However, understanding the complete guidelines…
Outsourcing Corporate Compliance in Rural Hospitals
Outsourcing Corporate Compliance in Rural Hospitals is increasingly seen as the most cost-effective means of having and measuring an effective corporate compliance program. And, lest we forget – it should…
HIPAA Breach Penalties and What To Do About Them
Understanding HIPAA breach penalties can be a problem for many providers. It can be a great challenge, in part, because of the myriad ways in which a breach can occur….
Revenue Cycle Management Process in Medical Billing – 5 Steps
Anyone who knows anything about medical billing knows there are serious issues when you’re trying to integrate a Revenue Cycle Management (RCM) process in medical billing. An essential understanding of…
Pay for Performance Reimbursement
The concept of pay for performance reimbursement isn’t new; it’s been circling the healthcare industry for over a decade. Yet, studies continue to show that it offers mixed results. In…
Medical Tourism Industry – A Focused Overview
The medical tourism industry continues to grow and, as a result of the rising costs of medical procedures in the United States, Central Europe, and other developed nations, patients and…
HIPAA Compliance Requirements
HIPAA settlement payments hit an all-time high in 2018 following year-long HIPAA compliance requirements audits conducted by the Department of Health and Human Services Office for Civil Rights. These monetary…
Outcome Based Reimbursement
Five years ago, most of the provisions of the Affordable Care Act came into play, and one of these provisions added outcome based reimbursement. It is designed to provide incentives…
Measuring Compliance Program Effectiveness – 3 Critical Questions
There have been several resources for measuring compliance program effectiveness. The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) put out “Measuring Compliance Program…
Healthcare Revenue Cycle Process
The healthcare revenue cycle process is a non-organic process – non-organic because steps cannot be reversed, skipped or circumvented to save time or collect money faster. Missing or skipping a…
HIPAA Encryption Requirements or Best Practices
HIPAA Encryption requirements? Not really! To be sure, encryption may not always be directly required, but it is often best practices. When it comes to HIPAA compliance, the way you…
Starting a Medical Tourism Business
Starting a medical tourism business is not easy, but mounting changes and regulations in western healthcare systems have prompted a boom in medical tourism. In fact, according to a recent…
How does Fee for Service compare to Value Based Reimbursement
The cost of medical care has outpaced inflation for several years now, and it shows no signs of slowing. Despite skyrocketing costs, care quality is not improving under the traditional…
OIG Workplan 2019: What’s New!
We are entering the second year of the OIG’s new approach to publicizing and managing its FY18-19 Workplan. Just like last year, the OIG Workplan 2019 is not a static document. …
Understanding HIPAA Policies and Procedures
In 1996, Congress enacted the Health Insurance Portability and Accountability Act (HIPAA) primarily to protect individuals and their personal health information (PHI) contained in medical records. HIPAA applies to all…
Revenue Cycle Management Outsourcing
According to a recent Black Book Survey, revenue cycle management outsourcing stood at $11.7 billion at the close of 2017 and is expected to climb to $23 billion by 2023….
What is HIPAA Compliance? What You Don’t Know Can Cost You.
If you work in medical billing or healthcare administration, you probably think you can answer the question: What is HIPAA Compliance? Yet, a recent Office of Civil Rights (OCR) audit…