Understand What is the Purpose of the CMS Conditions of Participation CoPs

CMS is a prominent organization that looks after healthcare programs like Medicare and Medicaid. They create a list of rules called Conditions of Participation (CoPs) and Conditions for Coverage (CFCs). These rules are like a checklist that hospitals and clinics must follow to be part of these progr... View More

Enhancing Denial Management Processes with AI

Artificial Intelligence has become a game changer in various industries, and from last year's emergence, it has found its way into healthcare. However, the healthcare industry has been tackling several challenges, including medical coding and billing intricacies, workforce shortage, and more. Cl... View More

AI Powering Precision: Revolutionizing CMS Prior Authorization

AI Powering Precision - Main Role of Artificial Intelligence in CMS Prior A

In October 2023, the president decided on some rules for how artificial intelligence (AI) can be used in healthcare. This is important because AI can be a powerful tool, but we want to make sure it's used safely. Part of these rules focus on using AI responsibly in healthcare. This means making ... View More

Common Tips for Behavioral Health Compliance and Quality Care

In healthcare organizations, it's really important to have a strong focus on following rules and guidelines. This is because a lot of what we do relies on the people working there and the way things are done. If we don't have consistent ways of doing things, there's more chance that thin... View More

Top 5 Best Practices For Complete Documentation Of Injections And Infusions

Top 5 Tips for Prior Authorization Success in Healthcare

Prior authorization, also known as precertification, predetermination, and pre-approval, is a health plan cost-control process in which healthcare providers such as hospitals or physicians obtain advance approval from the insurance plan to qualify the payment coverage for a specific treatment or ser... View More

Understanding Trauma-Informed Care: Healing with Empathy and Insight

Many people go through difficult experiences in their lives. While some people don't have lasting problems, those who have been through many bad things over a long time might struggle more. This can lead to issues like using drugs or alcohol too much, mental health problems, and even physical he... View More

Cybersecurity Challenges in Healthcare: Top 5 Tips for Cybersecurity Awaren

The healthcare industry becomes the top target of cybercriminals, accounting for 17% of all data breaches between 2020 and 2021, the highest among any industry. Cybersecurity threats have no signs of slowing down as in March 2023, the Department of Health and Human Services’ Office for Civil Right... View More

Top 5 Compliance Tips on HIPAA, Text Messaging, and Your Practice

After the pandemic, texting and telecommunications have become a convenient way to communicate for healthcare organizations and patients. More than 80% of Americans find text messaging efficient, affordable, and has better reach. While text messaging shares many benefits, it also comes with several ... View More

Deconstructing the 2024 Telehealth Updates

Imagine talking to your doctor from your couch instead of going to the office! That's telemedicine: video or phone calls for healthcare. It's great because it's convenient and more accessible, especially for specialists. It was a lifesaver during the pandemic, letting doctors and patient... View More

Compliance Training for Healthcare Staff: Building a Culture of Accountabil

In the healthcare industry, compliance is the only culture that employees should understand. Correspondingly, accountability of the healthcare employees matters in order to prevent significant damage to the organization. However, there are abundant ways to train healthcare staff regarding building a... View More

2024 Healthcare Compliance Trends: What Hospitals Need to Know

More than 60 million people across the nation are covered by the Centers for Medicare and Medicaid Services (CMS), and it plays a crucial role in offering healthcare services. If you oversee a long-term care facility, chances are you engage regularly with CMS in various transactions involving Medica... View More

Nursing Home versus Home Care: How Medicaid Cuts Shift the Balance