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…
Many providers have the belief that HIPAA should be treated like well-regarded advice from your mom: It's better to be safe than sorry. But that mentality is not always the…
ICD-10 Diagnosis Codes that identify weeks gestation of pregnancy and birth weight requirement when billing a delivery CPT Procedure Code Effective for Dates of Service beginning January 1, 2017, and…
The Centers for Medicare & Medicaid Services needs to step up its involvement in states' Medicaid integrity programs in order to strengthen oversight and identify overpayments, according to a new…
Medical coders play a crucial role in the revenue cycle process, as they help ensure health systems, hospitals and physicians are properly reimbursed for the services they provide. Here are…
The Health Insurance Portability and Accountability Act (HIPAA) requires covered entities to adhere to the most current International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code set as well…
Have you updated your reporting of malignant carcinoid tumors, viral hepatitis, GIST or ovarian cyst coding? You haven’t had to deal with annual ICD-10-CM updates until Oct. 1, 2016. Now…