Healthicity Blog

With the launch of the CMS TEAM Model, nearly 1,000 hospitals across the U.S. are entering a new era of accountability, care coordination, and financial risk. For the first time in recent history, CMS is mandating that selected hospitals take full responsibility for the cost, quality, and outcomes...

CMS is tightening enforcement of its hospital price transparency rule, with potential penalties exceeding $2 million per year per hospital. In the latest Compliance Conversations podcast, Dave Cardelle joins CJ Wolf to unpack the complexities of compliance and the real opportunities hidden within...

The Centers for Medicare & Medicaid Services’ Targeted Probe and Educate (TPE) program is one of the processes that Medicare administrative contractors (MACs) can use when providers are selected by medical review. CMS claims this review process is designed to help providers reduce claim denials and...

New year, new Work Plan updates from the U.S. Health and Human Services (HHS) Office of Inspector (OIG) General! Let’s take a look at some important new additions to review.

Most medical coders, auditors, and compliance professionals are aware of the Centers for Medicare and Medicaid Services (CMS) Targeted Probe and Educate (TPE) program. It is designed to help providers and suppliers reduce claim denials and appeals through one-on-one help. 

A quick riddle for you. What totaled $12.59 billion over the course of 14 million transactions?  The answer: payments made to physicians and teaching hospitals in 2022 from industries such as medical device and pharmaceutical companies.

New healthcare coding changes are less than two months away – but don’t panic!

With so many coding changes just around the corner, it’s hard to keep up – we’re here to help!