What Is Statistical Extrapolation and Why Does It Matter?
Extrapolation is a statistical method used to estimate values for an entire population based on a smaller, randomly selected sample. In healthcare audits, this technique allows auditors to review a manageable subset of claims and project the findings to the full universe, saving time and resour...
Exposing Hidden Risks: A Strategic Approach to FWA in Medicare Advantage
Medicare Advantage (MA) has reshaped healthcare coverage for beneficiaries, offering comprehensive benefits through private insurers. However, the program's expansion has also introduced complex challenges, notably fraud, waste, and abuse (FWA) that threaten its integrity and the well-being ...
Beyond Coverage: How Medicare and Medicaid Transform Public Health
Did you know that Medicare and Medicaid, established in 1965 under President Lyndon B. Johnson, have profoundly influenced public health in the United States? Initially designed to provide health insurance to seniors and low-income individuals, these programs have expanded access to care, reduce...
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
...
#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...
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...
