About admin

Author Archive | admin

AHA Calls for Bundled Payments Delay, Reform for BPCI Advanced

CMS should delay the BPCI Advanced application deadline until it provides information on target prices, attribution, and quality measures for the bundled payments, AHA advised. Though supportive of the Bundled Payments for Care Improvement Advanced (BPCI Advanced), the American Hospital Association (AHA) recently urged CMS to delay the model’s application deadline until the federal agency […]

Continue Reading Comments { 0 }

Coding Case Study: Documenting and Coding Asthma

Getting paid requires accurate documentation and selecting the correct codes. In our Coding Case Studies, we will explore the correct coding for a specific condition based on a hypothetical clinical scenario. Check out the following scenario involving a patient with asthma and see if you can choose the correct codes. First, some background information on […]

Continue Reading Comments { 0 }

Making Referrals Has Become a Nightmare

I need your help. I’m trying to figure out how to get rid of something that’s terribly broken in our process of taking care of patients, and I can’t do it alone. It’s time to kill the referrals process, get rid of them altogether. Every day, a huge proportion of the messages we receive through […]

Continue Reading Comments { 0 }

5 Key Observations on Trends and Technology to Help with Patient Estimation and Collection

Scott Palmer, CEO of Clariti Health, has dedicated his career to health IT in the ASC space, including founding and leading several companies over a 35 year career with products that continue to serve thousands of ASCs. Two years ago, he embarked on efforts to examine the biggest pain points for ASCs and how technology […]

Continue Reading Comments { 0 }

We are Now in an ICD-10 World – But is Data Better?

Unfortunately, the quality of data is driven less by opportunity and more by incentives for those creating the data. Prior to the implementation of ICD-10, the key selling point of the new coding set was that it provided the opportunity for more detailed data about the nature of each patient’s condition. In theory, this improved […]

Continue Reading Comments { 0 }

Why Employers Should Care About Medical Billing Errors

Errors on medical bills are a more significant problem than you might think. Experts say as many as 80% of medical bills in the U.S. contain errors, according to Derek Fitteron, CEO of Medical Cost Advocate, a medical billing review and negotiation firm focused on helping employees navigate the complexity of medical billing. For 25% […]

Continue Reading Comments { 0 }

When an E/M Code Can Be Billed with a Physical on the Same Day

Q: Can you clarify when an evaluation and management (E/M) code can be billed with a physical on the same day? A: This is always a difficult coding scenario to unravel, but there are a couple of things to keep in mind. Current procedural terminology guidelines for preventive medicine state: “If an abnormality is encountered […]

Continue Reading Comments { 0 }

HHS Issues 6-Month Delay to Common Rule Implementation

The Department of Health and Human Services, along with 15 other federal agencies, has issued a six-month delay to an Obama-era rule that provides health informatics researchers with greater access to EHR and patient-reported data. HHS posted the interim final rule (PDF) to the Federal Register on Wednesday, just days before updates to the Federal […]

Continue Reading Comments { 0 }

CDI and Medical Necessity: Closing the Gap Could Prevent Denials

Exactly what is medical necessity? To many, it is the belief that a service or procedure is warranted or justified for a patient. Others view it as a way for health plans to deny coverage for a service. The American Medical Association (AMA) defines medical necessity as “healthcare services or products that a prudent physician […]

Continue Reading Comments { 0 }

Medical Billing Codes Do Not Address Full Scope of Primary Care

Current Procedural Terminology (CPT) codes used for medical billing did not account for all the care provided by primary care physicians in about 60.3 percent of visits, a recent Journal of the American Board of Family Medicine study showed. The observational analysis of over 980 family physician-patient ambulatory visits revealed that CPT codes used for […]

Continue Reading

ICD-10 Coding: Three Ways to Improve Quality: Consistency, Collaboration, and Education

Quality coding plays a critical role in protecting revenue and reducing operational costs. Results of the 2nd Annual National Coding Productivity and Accuracy Contest were released in September 2017. Although accuracy rates were higher than reported following the same contest in 2016, quality remains significantly low compared to the 95 percent benchmark established in ICD-9. […]

Continue Reading

How to Code for ‘Problem’ Discovered During Preventive Medicine Visit

The Current Procedural Terminology (CPT) manual offers guidelines on how to code for a “problem” that is addressed during a preventive medicine service. The guidelines cover “insignificant or trivial” problems as well as those that are “significant.” “An insignificant or trivial problem/abnormality that is encountered in the process of performing the preventive medicine evaluation and […]

Continue Reading

MACRA: A Quick Study Guideline

The importance of learning and researching the details of MACRA cannot be overstated, especially since the topic is unknown to many healthcare entities. EDITOR’S NOTE: At the American Health Information Management Association (AHIMA) 2017 Convention and Exhibit, significant attention was given to the Medicare Access and CHIP Reauthorization Act (MACRA). The following is a summary […]

Continue Reading

7 Steps for Handling a Patient HIPAA Privacy Complaint

A patient voices a concern of privacy violation because the provider mistakenly emailed her medical treatment information to unrecognized email addresses. Your Notice of Privacy Practices correctly informs the patient of her rights under HIPAA to file a privacy complaint with your organization’s Privacy Officer and the Office of Civil Rights (OCR). As the provider, […]

Continue Reading

Amidst Opioid Epidemic, New Medical Codes May Have Muddled Data

The number of babies who were exposed to opioids in the womb jumped by 200 percent in Florida between 2015 and 2016 — to more than 2,500 cases — the biggest spike in the past decade, according to state data. But the number of newborns statewide who were diagnosed with opioid-withdrawal symptoms known as neonatal […]

Continue Reading

How Value-Based Care is Changing the Healthcare Landscape

There has been a shift in our healthcare system, whereby providers are being rewarded for better care, not more care. This transition from fee-for-service to value-based care is not only changing how patients are cared for, but also how providers are measured on their performance. At the heart of this new framework are the quality […]

Related Posts Plugin for WordPress, Blogger...
Continue Reading