Hospitals have relied on a relatively manual process and retrospective audits for coding compliance, but new technology is streamlining the process, allowing providers to get ahead of denials. Healthcare technology…
Pediatrics will see some important changes to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) that will take effect on Oct. 1. These include updates to both the…
The revolution in Blockchain technology has made its way to the healthcare industry and is already showing promising results in the technical advancements in health care. Healthcare Rallies For Blockchain, a…
The announcement is all but ensured to trouble providers already concerned about overreach. Federal healthcare oversight authorities have announced that they are expanding their “revocation and denial authorities” in an…
A look at the proposed Medicare Physician Fee Schedule. As you may be aware, the proposed Medicare Physician Fee Schedule (MPFS) rule for 2020 was officially published on Aug. 14,…
A recent AMA study found that in 2018, for the first time, employed doctors outnumbered those that owned, or had an ownership stake in, a practice. For independent practices, this…
Poor healthcare IT infrastructure has contributed to patient care problems at Indian Health Service (IHS) hospitals, concluded a recent report by the HHS Office of Inspector General (OIG). The report…
HIV/AIDS payments, in particular, are under the microscope. The new Patient-Driven Payment Model, or PDPM, makes radical changes to the Medicare payment model for nursing homes. One of the largest…
Care coordination and planning are becoming increasingly important to caring for the millions of Medicare beneficiaries suffering from two or more serious health conditions, such as diabetes and heart disease.…
When your job is converting medical documentation into codes, your knowledge of medical anatomy has to be shipshape. But you’ve got the added complication that the code set you’re using…
In countries like the US, citizens are investing in health insurance plans, which are directly increasing the demand for medical coders’. Recently got an opportunity to interact with a few…
Prior authorizations consume hours of physician time as they seek insurer approval for drugs and treatments. Health plans say prior auths improve the quality of care and manage healthcare spending,…
CMS has provided ICD-10 Procedure Coding System updates for the fiscal year beginning Oct. 1, 2019, and ending Sept. 30, 2020. Four takeaways: 1. The updated ICD-10-PCS codes are for…
The case continues even after two suicides. When does an audit go beyond the reasonable and become persecution? An act of tyranny by claim denial and extrapolation? Vernon Partners LLC…
There are 2,115 additions to the third quarter Medicare National Correct Coding Initiative (NCCI or CCI) practitioner edits that became effective July 1, 2019. The good news is that the…
The stories of Americans affected by surprise medical bills are hard to believe. A teacher with insurance was taken to an out-of-network medical facility when he suffered a heart attack…