CMS and AHIP Isn’t the Finish Line: It’s the Starting Gun for Prior Auth Innovation
Without systemic redesign, these efforts risk reinforcing the same pain points that made prior authorization a flashpoint for payers and providers.
Advancing Patient & Planet Health Through Proper Healthcare Waste Management
By prioritizing sustainability-minded and compliant waste management in the workplace, healthcare leaders can advance patient and employee well-being, as well as environmental and fiscally responsible programs.
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6 Aesthetic Certification Programs That Include Both Theory and Practical Training
Explore top-tier aesthetic certification programs that blend theory with hands-on training — perfect for health care pros ready to elevate their practice
Best Practices in Managing Medical Equipment Rollouts
Successful implementation makes all the difference between a seamless changeover and a poorly executed one that interferes with the delivery of patient care.
Putting Part 2’s Data Privacy Protections into Play: 3 Key Considerations
If the guidelines for data sharing are not adhered to by providers, then all the work that has gone into revising this regulation will have been for nothing. But the road to compliance doesn’t have to be overwhelming. Here are three essential steps for healthcare leaders in navigating the soon-to-be Part 2 landscape.
4 Practice Policies that Help Maintain Behavioral Health Practice Success
Running a behavioral health practice requires balancing patient volume and case diversity, while maintaining operations. Transparent practice policies are necessary for success and ensuring high-quality, consistent patient care.
Common MRF Mistakes Hospitals Are Making in 2024
Updated schema requirements are easy to mix up — here are a few simple solutions
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The Definitive Guide to Medical Billing Outsourcing: 5 Top Companies
In today’s healthcare landscape, your choice of medical billing partner directly impacts your bottom line. What are the best medical billing outsourcing companies, and which one is right for you?
Medicare Advantage Audit Ready with AI
Adding generative AI and other AI tools to coding and chart review practices streamlines a complex process and better positions plans for risk adjustment audits.
From FOMO to FOMU: A Framework for Getting AI Right
Healthcare is a highly regulated industry, and any use of AI within it is dealing with the most sensitive data. In order to ensure you’re not putting you, your company or patients at risk, consider an evaluation framework for any AI tool that considers these three things.
Corporate Compliance in the Era of TEFCA
A culture of compliance means truly valuing an adherence to industry standards, rather than looking at SOPs as a series of boxes that need to be checked in order to claim that requirements have been met.
From Risk to Trust: Tackling Inefficient Provider Verifications in 2024 and Beyond
The NCQA proposed standards updates are just one part of a healthcare landscape undergoing rapid transformation, but the imperative for optimizing operational processes has never been clearer.
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Improving Medical Billing to Cut Payment Bottlenecks
Yusuf Qasim, President of Payments Optimization at Zelis, discussed how the company is transforming healthcare payments from a fragmented, patchwork system into a modern, digital infrastructure.
Tax Challenges for Healthcare Accounting Teams Bring Opportunity for Innovation
A good outsourced partner can work alongside in-house accountants and stay on top of the moving target of healthcare accounting regulations, addressing tax risks and identifying cost-saving opportunities.
The Rising Stakes of Healthcare Data Privacy in 2024: The Need for Practical Guidance
Where we’ve been, where we’re going, and how healthcare organizations can protect themselves from privacy risks caused by the Meta pixel and other third-party trackers
Demystifying Coding Compliance: 3 Key Strategies for Navigating the Regulatory Waters of RCM
Organizations must take a proactive approach by implementing a comprehensive education program, internal audits, and automation technology.
Hospitals Finally Reached Widespread Price Transparency Compliance in 2023
Hospitals markedly improved their compliance with price transparency regulations in 2023, according to a new report. It found that more than 90% of hospitals have posted a machine-readable file containing gross charges, negotiated charges and cash prices for the services and items they provide.
How WedMD Is Helping Providers Stay Compliant When Using Web Tracking Tools
WebMD Ignite — the company’s division that offers tech solutions to providers and health plans — teamed up with healthcare privacy platform Freshpaint. Through the partnership, WebMD Ignite is seeking to help its customers — which include organizations such as Providence, Trinity Health, Advocate Aurora, VillageMD and Centene — use web tracking technology to grow their businesses while staying clear of data privacy risks.