Retrieving Billions in Overpayments by CMS

Retrieving Billions in Overpayments by CMS

Amid swirling accusations that Medicare Advantage Organizations (MAOs) are overbilling the U.S. government and calls for better oversight, the Centers for Medicare & Medicaid Services announced in early February that it would investigate overbilling by those plans. They expect to recoup 4.7 billion dollars through this program.
This article focuses on the relatively young technologies that enable CMS to uncover overbillings, whether they be errors or fraud. The article is based on an interview with Kel Pults, chief clinical officer and vice president of MediQuant. A future article will explain how Medicare Advantage plans are trying to improving data collection and reporting,…

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VinBrain harnesses Stanford data to improve radiology AI

VinBrain harnesses Stanford data to improve radiology AI

Vietnamese healthcare AI developer VinBrain has started a new partnership with Stanford University to enhance AI medical imaging.Based on their latest data use agreement, Stanford will initially provide VinBrain access to about 240,000 anonymised medical images and reports to train and test the AI on its DrAid clinical decision support platform while also helping improve the accuracy of an information extracting method for structuring radiology reports called RadGraph.
WHY IT MATTERS
According to VinBrain, its latest partnership with Stanford aims to enhance efficiency in radiology reports while “tackling complexity, ambiguity, and limitations in medical image interpretation.”
Through Stanford’s support, the company will be able…

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Talkspace Launches New Mental Health Portal for Employers

Talkspace Launches New Mental Health Portal for Employers

Virtual behavioral health provider Talkspace unveiled a new product Thursday that provides employers with access to a library of mental health resources that they can share with employees.
New York City-based Talkspace serves employers, payers and consumers, and provides self-guided mental health programs, therapy and psychiatry. Its new product, Talkspace Engage, aims to help employers promote their mental health benefits to their employees, a challenge that many companies struggle with, said Erin Boyd, chief growth officer of enterprise at Talkspace. “One resounding common theme that we heard among [employers] was that, ‘I don’t know how to get people to use these benefits…

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Epic remains Best in KLAS for overall software suite for 13th year

Epic remains Best in KLAS for overall software suite for 13th year

In addition to winning overall, Epic was named top Overall Physician Practice Vendor based on provider feedback in this year’s Best in KLAS awards. The health IT giant also earned plaudits in 13 other categories, the research firm announced Wednesday.Of note, Impact Advisors and Nordic are tied as co-winners of the Overall IT Services category. 
Impact Advisors also took top placements in ERP Implementation Leadership, Financial Improvement Consulting and Security & Privacy Consulting Services categories while Nordic won for HIT Core Clinical Implementation Leadership.
The KLAS announcement noted that Nordic also scored above 90 in four separate services segments, which is detailed in 2023…

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New York approves AI-driven breast cancer diagnostic

New York approves AI-driven breast cancer diagnostic

With Clinical Laboratory Evaluation Program assay validation, the company’s Clinical Laboratory Improvement Amendments-certified lab can begin testing patient samples.WHY IT MATTERS
Along with New York State Department of Health clinical and analytical validation of this use of array morphology, the results of the PDxBr test were reproducible.
“Consistent with our mission of improving healthcare, PDxBr has shown to be an effective prognostic tool to further improve risk stratification over current histopathology methods,” said Wayne Brinster, CEO of PreciseDx, in an announcement.
The company says the AI technology has now proven its ability to enhance invasive breast cancer pathology interpretation with objective, quantifiable and accurate…

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HammondCare beefs up IT monitoring across its aged care network

HammondCare beefs up IT monitoring across its aged care network

Not-for-profit aged care service provider HammondCare has tapped German enterprise monitoring solutions provider Paessler to proactively monitor its IT infrastructure nationwide.With more than 5,100 dedicated staff and volunteers, HammondCare delivers aged care, dementia care and palliative care to around 34,000 clients in over 92 service locations across Australia.
It has rolled out the Paessler PRTG, a round-the-clock network monitoring software, across its 76 care facilities. 
WHY IT MATTERS
“HammondCare’s primary objective in implementing the Paessler PRTG monitoring platform was to provide our team with proactive insights and alerts to minimise the regular incidents that were occurring previously,” infrastructure and cloud manager Kasun Haputhanthri said.
Since deploying…

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What Is The Enterprise Master Patient Index?

What Is The Enterprise Master Patient Index?

The enterprise master patient index is a database that maintains a definitive record of all patients within a healthcare organization. It is used within an overall process called patient identity management in healthcare. The EMPI is used to positively identify patients for the purpose of providing care, processing billing, and the exchange of data among other entities. Sometimes called the corporate ID, the purpose of the EMPI is to ensure that all patient data is accurately and consistently recorded and maintained, and to prevent duplicate records or errors in patient identification. It is also used to facilitate the exchange of patient…

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