How it Works: Health Insurance Fraud Investigation
The U.S. government won over $5 billion in healthcare fraud cases in 2021 according to the HHS Annual Report. That’s a huge number—but it only covers the dollar amount of fraud successfully found through investigations and reporting. Combatting the billions of dollars in fraud each year is the w...
How the Inflation Reduction Act will impact Medicare drug prices
The signing of the Inflation Reduction Act in August of 2022 brought some immediate relief for Americans with Medicare prescription drug coverage and will continue to drastically impact drug prices as implementation continues.
Already in effect as of January 2023: a $35 cap per month on...
Quality Data has to Lead the AI Charge
Author: Natasha Williams, Chief Operating Officer
There is a wave of excitement in the industry surrounding artificial intelligence (AI), and not without reason. AI, with its ability to synthesize massive quantities of information at lightning speed, promises limitless possibility. I share in...
#TechTalk: “Why the “sprint” to Agile?”
Technology doesn’t have to be complicated. IntegrityM CTO Swathi Young’s #TechTalk series is designed to provide quick, digestible explanations of the latest trends in healthcare technology and innovation so that you can stay ahead of the game before you finish your morning coffee.
The Agile
...
What you need to know about the 2021 Open Payments Program Expansion
IntegrityM strongly encourages new ‘covered recipients’ to familiarize themselves with the Open Payments system, so that they can have a successful experience in CY2022.
Open
Payments Program Background:
Under the Physician Payment Sunshine Act (Section 6002 of the Patient Protection and...
#TechTalk: What is Artificial Intelligence, Anyway?
Technology doesn’t have to be complicated. IntegrityM
CTO Swathi Young’s #TechTalk series is designed to provide quick, digestible
explanations of the latest trends in healthcare technology and innovation so
that you can stay ahead of the game before you finish your morning coffee.
Artificia...
Four Schemes to be Wary of Amid Soaring COVID-19 Fraud Reports
While combating fraud, waste, and abuse is a federal
initiative upheld by each state, administrators achieve this through various means.
Some state OIGs report that their work is primarily focused on beneficiary
fraud, while some work in both beneficiary and provider fraud. Furthermore, st...
IntegrityM Audit Guide Template
Author: Jennifer Tryder, RHIA, CHC, Audit Program Director, IntegrityM
An audit guide is a documented step-by-step method for conducting an audit focusing on objectives and scope. An audit guide supports many functions including serving as the primary source for the audit process, assi...
“Excellence as the Bottom Line”: How to Leverage Quality Management for Tangible Business Success (Part II of IV)
A well-known truism from philosopher Aristotle, is: “We are what we repeatedly do. Excellence is not an act, but a habit.” When running a small business, your world is governed by commitment to excellence and continuous improvement of employee engagement, customer service, operations, prog...
“Excellence as the Bottom Line”: How to Leverage Quality Management for Tangible Business Success (Part I of IV)
Author: Natasha Williams, Chief Operating Officer, IntegrityM
A well-known truism from philosopher Aristotle, is: “We are what we repeatedly do. Excellence is not an act, but a habit.” When running a small business, your world is governed by commitment to excellence and continuous imp...
