By Ritesh Ramesh – Healthcare finance executives face an intensifying storm of audits, denials, and clawbacks that threaten their organization’s financial stability. Couple that with an environment of heightened regulatory and payer scrutiny, and it becomes clear that proactive risk monitoring and AI-driven compliance strategies are no longer optional—they are imperative.
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By Matthew D. Bayley MD – Each year the Medical Group Management Association surveys hundreds of group practices to assess how industry regulations are impacting them. Just as in previous years, the most recent survey shows things are getting worse, not better.
By Scott Overholt – Payer-required administrative tasks are a burden most providers know all too well. They are a daily source of frustration, diverting time from mission-critical work and often delaying patient care. Legislation impacting audit and authorization processes is in constant flux, only increasing confusion about payer requirements and regulations.
By Art Gross – The Health Insurance Portability and Accountability Act, better know as HIPAA, was passed by Congress in 1996 and called for the…
By Greg Waldstreicher – A decade ago, there was very little noise in the healthcare industry about Business Associate Agreements. In fact, most professionals outside of legal and compliance departments had little knowledge of these important patient data protection directives.
By Matt Fisher – Questions often arise as to what terms need to be and should be included in a business associate agreement. The distinction between “need” and “should” is very important.
By Susanna Partrick – Nearly eight out of ten healthcare internal auditors in a recent survey by PwC believe risks are increasing. As a result, almost nine out of ten say they have gone through or will soon be involved in significant business transformation.