Emergency departments across the United States charge adult patients 340% more than what Medicare pays for services, but minorities and the uninsured receive the biggest bills, according to new research…
Revisions include 322 more changes than CMS proposed in April The final updated ICD-10-CM codes for 2018, posted on the Centers for Medicare and Medicaid Services’ (CMS) website, contain 360…
There’s a smart trend we’re starting to see that starts with a simple equation: E + D = O Where E=expertise, D=data, and O=optimization. Carriers are starting to discover that…
Medicare is a government-provided health insurance program designed to assist certain people with hospital care, medical costs, and other expenses. Qualifying beneficiaries are people who are 65 or older, those…
In the ICD-9 era, there were universally accepted benchmarks to measure coding professionals’ productivity. Now, more than 18 months after the ICD-10 implementation date, the challenge is to do the…
Medicare’s Office of Inspector General (OIG) has issued a sixteen-question survey to many ambulance service suppliers. The survey is focused on SNF patients, and specifically why the ambulance service has…
How do bundled payments fit into the growing value-based reimbursement ecosystem? The shift to value-based care has driven public and private payers to redesign reimbursement models that stress accountability for…
CMS pushed back the implementation of compulsory Medicare cardiac and orthopedic bundled payment models and the Cardiac Rehabilitation Incentive Payment program until 2018. CMS recently delayed the launch date of…
The Centers for Medicare & Medicaid Services (CMS) intends to align its Medicare plans, including Part D prescription plans, with the Centers for Disease Control and Prevention (CDC) opioid prescribing…
The Centers for Medicare & Medicaid Services (CMS) has exempted about two thirds of physicians and other clinicians who provide care to Medicare beneficiaries from the Merit-based Incentive Payment System…
Implementing claim denials management best practices is key to ensuring hospitals maximize claims reimbursement revenue and prevent denials. Healthcare cost control continued to top hospital priority lists in 2017. But…
Q: One of our physicians is getting conflicting information regarding the ICD-10 codes E66.01 and E66.9. We have been coding E66.9 for Body Mass Indexes (BMIs) between 30-34 and E66.01…
Physician Computer Assisted Coding Market for Professionals Report 2017-2023 provide Industry shares, strategies, analysis and forecasted Computer Assisted Coding Market to reach $2.5 billion by 2023. Report also provides Research…
By the time the late President Lyndon B. Johnson signed the law establishing Medicare and Medicaid in 1965, the health care community was already figuring out how to maximize its…
The ICD-10 transition provided Humana with the "perfect opportunity" to develop a more detailed diabetes risk stratification tool. In an effort to improve the delivery of targeted chronic disease management…
While it might surprise some folks that five Modesto doctors are among those facing fraud charges in a $40 million medical billing and kickback case based in Southern California, it…