Audits of Telehealth Services During COVID-19
Relaxed telehealth restrictions is a necessary step to limit potential COVID-19 exposure in physician offices in the emergency period. With this change, unfortunately, the US Justice Department estimates telehealth-related fraud has expanded significantly since early 2020 – approximated at 4.5 billion dollars.
Fighting Fraud in Medical Nutrition Therapy
The role of nutrition in chronic disease management is especially crucial, as it is a modifiable risk factor for many conditions such as chronic renal failure (CRF), diabetes mellitus (DM), obesity and coronary artery disease (CAD). Payers who bear significant long-term healthcare utilization burdens due to obesity and cardiovascular risk factors may determine that Medical Nutrition Therapy (MNT) preventive coverage is a cost-effective policy approach for their beneficiaries.
Keeping a watchful eye on telehealth claims
Telemedicine has grown significantly in recent years due to new technologies and consumer demand. Payer reimbursement policies, on the other hand, are slow to adapt to the new services.
When fraud causes patient harm, and how to find it before it does
It’s been called the most sinister, the most egregious, the worst kind of health care fraud – providers performing medically unnecessary procedures. When this type of fraud makes the headlines, it is indeed sensational.
Context Goes to Washington as Exhibitor at 35th Annual SIIA Conference
Conference attendees will have the chance to learn about a new product this year - just recently, Context introduced a new Inpatient UCR module as part of its DecisionPoint™ Health Payment System. With the increasingly high cost of inpatient services, many valued UCR customers have been looking for a way to benchmark inpatient facility claims. As the trusted source for UCR fee data (including Medical, HCPCS, Anesthesia, Dental and Outpatient), Context has developed an independent source for inpatient charges for more than 740 Diagnosis-Related Groups (DRGs).