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…
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…
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…
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…
Stakeholders argued that the 2018 MACRA implementation rule will slow the value-based care transition and does not promote quality over quantity. Industry groups, including the American Medical Group Association (AMGA)…
Hospitals, health systems, and post-acute care providers spend almost $39 billion annually on administrative tasks related to regulatory compliance, the American Hospital Association (AHA) reported. “As a result of this…
When President Trump declared the opioid crisis a public health emergency Thursday, he noted that "last year we lost at least 64,000 Americans to overdoses." He is not incorrect. A…
A shortage of experienced nurses has hit the United States, particularly in rural communities, forcing many hospitals in the Midwest to recruit nurses from one another. One way hospitals have…
In the Medicare Advantage (MA) context, "risk adjustment" is the process by which the Centers for Medicare & Medicaid Services (CMS) reimburses Medicare Advantage Organizations (MAOs) based on demographic factors…
Once a year, the National Center for Health Statistics (NCHS), the federal agency responsible for the use of the International Classification of Diseases – 10th revision (ICD-10) in the US,…
Unfortunately, many healthcare providers are missing out on things like electronic billing, email capture. A new survey by the Medical Group Management Association suggests providers, especially hospitals, are missing out…
A federal lawsuit claims that UnitedHealth Group, the largest Medicare Advantage insurer in the country, is coding medical claims inappropriately for monetary gain. But while the lawsuit doesn't involve physician…
A new government report finds that Medicare improperly paid acute care hospitals for outpatient services they provided to patients who were inpatients at other facilities. And now Medicare wants the…
Changes are coming with Evaluation and Management (E&M) coding guidelines. I will use this space to explain why these changes will be both a good thing and a challenge to…
Accurate, efficient revenue cycle management is essential to maintaining positive cash flow in a healthcare facility. Maintaining positive health care finances requires that claims processing and payments are effectively managed…
CMS released a proposed rule that would update the Hospital Outpatient Prospective Payment System and the Ambulatory Surgical Center Payment System. Here's what you should know about the ASC-related changes:…