Customized Solutions and Services

At Engage Health, we specialize in helping healthcare organizations navigate the complex landscape of medical and regulatory policies to ensure accurate reimbursements for services rendered. Our team of experts understand the challenges that healthcare leaders face and are dedicated to providing strategic solutions to address them. Trust us to be your partner in achieving optimal reimbursement outcomes.

Payment Accuracy Remains a Challenge

The persistence of payment errors is a significant challenge for healthcare organizations as it can lead to a multitude of issues including financial losses, compliance issues, and potential legal action. These errors can lead to costly investigations, fines, and legal consequences. In addition, incorrect payments can negatively impact patient care as well, as resources and staff time are diverted to resolving the issue instead of delivering care.

At Engage Health, we understand the challenges healthcare organizations face in ensuring payment accuracy and compliance with payer regulations. Our team of experts is well-versed in navigating the complexities of healthcare reimbursement and can help organizations identify and resolve payment errors quickly and efficiently. By partnering with Engage Health, healthcare organizations can ensure they are optimizing payment accuracy while minimizing compliance risks.

PROVIDERS AND SUPPPLIERS BEWARE

PROVIDERS AND SUPPPLIERS BEWAREā€¦recent audit and program integrity activity has the potential to wreak havoc on your business. The Centers for Medicare and Medicaid Services (CMS), through their contractors, as well as through changes to their manuals, coupled with activity by the HHS Office of Inspector General (OIG) and Department of Justice (DOJ) indicates that …

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CMS Updates Medicare Manual regarding Advance Beneficiary Notices

A Must-Read for Billing Departments The Centers for Medicare and Medicaid Services (CMS), on July 14, 2021, issued Transmittal 10862, Change Request 12242 (r10862CP.pdf (cms.gov)), editing, changing, and reorganizing section 50, chapter 30 of the Medical Claims Processing Manual (MCPM) (Pub. 100-04) (implemented and effective October 14, 2021) which specifically deals with the Advance Beneficiary …

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CMS Enacts New Changes to Medical Review Activities

CMS Proposes New Regulatory Language to Address Contractor Medical Review Requirements In July 2021, the Centers for Medicare and Medicaid Services (CMS) released the following proposed rule: Medicare Program: CY 2022 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Provider Enrollment Regulation Updates; …

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