Here are the facts: Medicare is one of the largest insurance programs in the United States, and every year it helps insure more than 49 million seniors and other beneficiaries. And,…
As insurers prepare to switch to ICD-10, some are shifting their focus to coordinating with providers, particularly small to medium doctor offices, to ensure a smooth transition next year to…
The transition to ICD-10 will cost healthcare organizations and providers in a number of ways, not just in dollars and cents. “The cost is not necessarily in dollars,” says Sandra…
BuildYourEMR today announces the availability of SmartSheet10™ as a standalone solution. SmartSheet10 is an ICD-10 toolkit that provides a unique way for healthcare providers to convert their ICD-9 codes cheat…
Given that there is one more year to go, the majority of the healthcare organizations should be prepared and ready to accept ICD-10 codes. Payers face a major challenge in…
The OIG has called on CMS to strengthen activities to prevent improper Medicare payments, including enhancements to the Recovery Audit Contractor (RAC) program. For instance, the OIG notes that RACs…
Risk Managers and workers’ compensation claim managers normally know the purpose of medical bill review is to reduce medical bills to the state fee schedule or to the previously agreed…
Contractors hired by Medicare to audit the payment records of healthcare providers have a good track record spotting improper billing, the Department of Health and Human Services Inspector General concluded…
The number of Recovery Audit Contraction (RAC) requests for medical claims reviews has increased “dramatically” since 2012, according to the American Hospital Association’s (AHA) newest RACTrac survey. More than 1200…
Follow these basic tips to ease the training for ICD-10 The world Health Organization had implemented the ICD-10 diagnostic coding system a long time back to replace ICD-9. The primary…
We all hope the question won’t be necessary, but the industry-wide climate of fear and dread that has surrounded ICD-10 demands an answer. What will you do if you or…
Gov. Pat McCrory signed legislation into law Wednesday that he said will help North Carolina consumers make better health care decisions and aid his administration in running state government more…
ICD-10 testing will be more complicated than sending medical claims to healthcare payers and asking, "How's that?" There are some best practices that can make or break your ICD-10 transition:…