Managing Denials After ICD-10
Healthcare providers will need a denials manager who can track denials and communicate with healthcare payers.
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November 14, 2014
5 Steps To Address The Coding Talent Shortage In 2015
Physician groups, hospitals and coding support companies have been gearing up to address the many changes required to meet the challenges of the upcoming conversion to ICD-10-CM/PCS.
November 13, 2014
Medicare Coding Errors to Avoid: Add-on, Place of Service, and Modifiers
Medicare audits have revealed recurring errors in billing with add-on and place-of-service codes. In addition, Medicare continues to receive claims that appear to be duplicate because they lack an appropriate modifier. Here are some guidelines for correct billing.
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November 12, 2014
Medical Records: Top Secret
MANY readers were shocked by my recent article about Peter Drier, who received a surprise bill of $117,000 from an out-of-network assistant surgeon who helped out during his back operation.
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November 10, 2014
CMS Releases The 2015 Medicare Physician Fee Schedule
The Centers for Medicare & Medicaid Services (CMS) issued the 2015 Medicare Physician Fee Schedule (Medicare PFS) on October 31, 2014.
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November 6, 2014
How To Tell If ICD-10 Implementation Will Be Delayed Again
While Tuesday's election was important for many reasons, none of them have a direct impact on the ICD-10 debate.
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November 5, 2014
CMS Update Policies, Payment Rates for Dialysis Facilities for 2015
On Oct. 31, the Centers for Medicare & Medicaid Services issued a final rule that will update payment policies and rates under the End-Stage Renal Disease Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after Jan. 1, 2015.
November 3, 2014
Examining the Basics of the Health Care Revenue Cycle
The health care revenue cycle is more than just collecting bills and is a pillar of a successful organization.
October 29, 2014
How and Where to Look Up CPT Codes for Free
As patients, we don't have the thousands of dollars it costs to tap into the extensive database information required for the entire body of CPT codes. But the AMA does offer us an easy way to look up one code at a time, for free.
October 27, 2014
Why Physician Practices Need To Build An ICD-10 Bridge
The ICD-10 mandate may be delayed another year, but providers and EHR vendors shouldn’t view the reprieve as an opportunity to relax.
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October 22, 2014
Physicians May Soon Be Paid For End-of-Life Discussions
The American Medical Association (AMA) has submitted codes that could finally lead to Medicare reimbursement for end-of-life and advanced care conversations, five years after a previous effort was squashed when…
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September 11, 2014
A Guide to Negotiating Medical Bills
Did you know that negotiating your medical bills could potentially save you thousands? When you open a medical bill, your eyes likely immediately fall on the total due. For many…
September 10, 2014
The Role of Claims Data in HealthIT: The Good, The Bad and The Ugly
As we move towards building a universal patient-centered data platform in health IT, several sources of data are useful. Data coming from transitions of care, clinical summary documents (C-CDAs) which…
September 3, 2014
5 Reasons Health Insurance Didn’t Pay Your Bill
How many times have you gotten a medical bill for more than you were expecting? Chances are, it's happened before, and you're not the only one who's been shocked at…
August 18, 2014
An Out-of-Control Medicare Audit
What happened to Eastern Carolina internal Medicine (ECIM) in Pollocksville, North Carolina is a provider’s nightmare about government oversight run amok. A Medicare audit began as a medical records request.…
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July 15, 2014
The Unethical Practice of Medical Up-Coding
No one enjoys opening medical bills — or paying them, for that matter. While the average American experiences slight bouts of sticker shock whenever a large procedure or unexpected test…
June 25, 2014
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