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Upcoming Healthcare Regulations and Their Impact on Healthcare IT

Healthcare IT Today

To help out, we reached out to our amazing Healthcare IT Today Community to see which healthcare regulations they foresee having a big impact on healthcare IT. This type of document will require not only top-notch billing tools but also new levels of contractual collaboration between separate provider entities.

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Fixing Medicare Advantage Payments

Healthcare IT Today

There’s widespread consensus that payments to Medicare Advantage Organizations (MAOs) are a mess. These programs, which care for more than 30 million of the nearly 64 million Medicare enrollees , operate on the cutting edge of health care and suffer serious problems in data collection and billing.

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Policy Ingredients for Real-Time Improvements in Health Care, Prior Auth, and Claims

Healthcare IT Today

In a fast-paced exchanged with John Lynn of Healthcare IT Today, Rucker covers regulations and evolving data exchange standards that foster interoperability and data analytics. Watch the video for more details about pressures on Medicare Advantage plans, rules about prior authorization, FHIR APIs, and more. Tell us what you think.

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Arizona telehealth company owners plead guilty in $64M scheme

Healthcare IT News - Telehealth

As outlined in court documents , marketers identified Medicare and TRICARE beneficiaries to target for expensive medications – such as pain creams, scar creams, eczema creams and migraine medication – and durable medical equipment, including wrist, shoulder, knee and ankle braces. " WHY IT MATTERS. ON THE RECORD.

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Billing Medicare and Private Payers for Telehealth Visits: What to Expect Post-Public Health Emergency

Healthcare IT News - Telehealth

Prepare Now for Anticipated Changes to Medicare and Private Payer Rules. The Centers for Medicare and Medicaid Services (CMS) is expected to issue new rules for telehealth in the release 2021 Physician Fee Schedule later this year. Today, Medicare reimburses for specific services when delivered via live video.

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2023 Benchmark Report: Healthy Bottom Lines are Reliant on Cross-Functional Team Collaboration, Technology, & AI Investments

Healthcare IT Today

Many include tight deadlines for initial response and appeals and have substantially greater Audit Documentation Request (ADR) letters that in some cases exceed 100 pages. Higher denial rates and increasing audit demands underscore the need for operational efficiency in billing, coding, and clinical documentation to enhance profitability.

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5 Useful Insights into Government Healthcare Plans For Payers

BHM Healthcare Solutions

Plan Differences: Understand Medicare, Medicaid, CHIP, VHA, TRICARE distinctions. Compliance Mastery: Follow regulations, document accurately, process claims timely. Tech Benefits: Use EHRs, analytics, telehealth to improve efficiency and care.

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