Nursing homes are questioning if a proposed CMS pay model could pay them less for services provided to Medicare patients. On Friday, the CMS proposed the Patient-Driven Payment Model which…
Clinical documentation improvement (CDI) ensures that health services are accurately documented and helps healthcare coders and physicians work toward improved patient care while also streamlining productivity. When meaningful clinical data…
Prior to undertaking the necessary work against this set of activities, review Parts I and II of this series. Review definitions, and give more than passing glance at the ICD-10…
(Editor’s Note: Dr. Terri Lewis has been very critical of the CDC for not requiring data collection about chronicity or context of chronic disease. She has been discussing this issue…
(Editor’s Note: Dr. Terri Lewis has been very critical of the CDC for not requiring data collection about chronicity or context of chronic disease. This is the first of a…
Medicaid improper payments, including fraud, have spiked in recent years, reaching $37 billion in 2017, according to a government watchdog agency. And the Centers for Medicare & Medicaid Services (CMS)…
Billing can be a frustrating part of physicians’ practices at a time when reimbursement is declining and administrative burdens are increasing on physicians and hospital systems. Adrian Velasquez, Wisconsin based…
Dr. John Cullen's four-physician family medicine practice in Valdez, Alaska, employs three full-time staffers who work on insurance and patient billing. A fourth full-timer focuses on obtaining prior authorizations from…
New identification cards the government is sending out to all Medicare recipients in an effort to deter fraud may actually end up encouraging scammers and hindering physician billing, according to…
In a weekly e-newsletter, Regent Surgical Health highlighted the key ways ASCs fail to manage risk and explained how to turn those shortcomings into opportunities for growth. Here are four…
Infections occasionally have a knack for developing resistance to treatment, and when that happens, costs add up, according to a new study published in Health Affairs. Resistance adds more than…
Patient financial responsibility is on the rise, according to findings from a TransUnion Healthcare analysis revealed at HIMSS18. Patients saw their average out-of-pocket costs increase 11 percent in 2017, growing…
The Trump administration twice last week demonstrated its interest in simplifying the administrative burden of electronic health records (EHRs) for physicians. Separately, a major new study suggests these high-tech medical…
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…
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…
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…