Louisiana posted the highest rate of Medicare being overbilled for services in the nation in 2015, with providers charging an estimated $1.25 billion more than they should have, according to…
Physicians often say they feel like the rules, standards and policies regarding the way they practice medicine change all too frequently. In 2016, there are several key issues physicians should…
Some experts are predicting a large spike in denials beginning on Oct. 1, 2016 when the Centers for Medicare and Medicaid Services will require claims to be more specific. Forward-looking…
Helping patients meet their financial obligations will, in turn, allow healthcare organizations to protect their valuable revenue streams in a time of financial change. With the ICD-10 conversion behind us,…
Just as the Ice Age eventually ended, so has the ICD-10 coding freeze. CMS recently announced that roughly 6,000 new codes will be added this October, which will be the…
The reason that there has been such a large rise in codes for the ICD-10 coding system is due to a partial freeze that occurred before the implementation deadline on…
Just how safe is the cloud and can we trust online software to keep sensitive medical billing data secure from a breach? In theory, the cloud is supposed to do…
Businesses, counties and municipalities could see a potentially significant increase in workers’ compensation benefits under legislation introduced in the House of Representatives involving permanent partial disability awards that have been…
SPELLING OUT MEDICAL NECESSITY Q: Does a diagnosis code alone support medical necessity for lab tests? Shouldn’t there be something in the note documenting a sign/symptom or current status of…
One of the things we are worried about is how ICD-10 implementation affects reimbursements for healthcare providers. And since Oct. 1, we've saying it's too early to tell. That's mostly because…
As it was billed and touted, ICD-10-CM/PCS gives medical personnel vastly expanded powers of specificity when diagnosing diseases and other health issues. Yet that greatly enhanced specificity comes with a…
Unreliable provider communication leaves patients vulnerable to expensive and potentially harmful medical errors, delays the medical billing process, and distorts quality of care. Reducing claims reimbursement waste demands a closer…
"Upcoding" means reporting a higher-level service or procedure or a more complex diagnosis, than is supported by medical necessity, medical facts, or the provider's documentation. For example, reporting a diagnosis…
Z23. That’s the ICD-10 billing code for an immunization encounter. It’s also the only code that stumped the team at Arlington, Virginia-based Privia Health, a national medical group. “It’s a…
After months studying a growing balance billing problem, Pennsylvania Insurance Commissioner Teresa D. Miller suggests patients should be removed from the dispute. In a public comment period that ends Feb.…
2016 may be a big year for revenue cycle management. Healthcare organizations see steady claims denial post-ICD-10 implementation and remain focused on value-based care models. Healthcare organizations are focused on strengthening revenue…