Month: July 2018

You’ve seen the headlines splashed on TV and across the internet: data breaches hit national businesses such as Target, Chipotle, and many large healthcare systems. But data breaches don’t just affect large corporate entities, they affect small healthcare organizations as well. Take the case of Holland Eye Laser Surgery in March 2018. Their five-provider group […]

Artificial intelligence can alleviate revenue cycle management challenges About 64 million adults in America struggle to pay their medical bills. In fact, one in five Americans is considered to have delinquent medical debt. As high-deductible health plans (HDHPs) have grown in popularity over the past couple of years, patient financial responsibility continues to increase, making […]

Understanding the terms and provisions in a payer contract is key to maximizing reimbursement, preventing denials, and operating a smooth revenue cycle. Providers are in the business of keeping their patients healthy. But confusing payer contracts riddled with “legalese” and other complicated provisions can get in the way of improving patient outcomes. Payer contracts define […]

The Centers for Medicare & Medicaid Services (CMS) is modifying its Medicare coverage policy for continuous glucose monitors (CGMs) to support their use in conjunction with smartphones, including the data sharing function CGMs provide. Medicare coverage of therapeutic CGMs began in January 2017, but the policy limited their use in conjunction with smartphones. CMS is […]

A decade ago, CMS enacted Hospital Inpatient Prospective Payment System (IPPS), a policy that penalizes hospitals for hospital-associated conditions (HAC) not present during admission. Recent research published in Infection Control & Hospital Epidemiology has shown the program has had minimal impact on hospital reimbursement. The researchers also found associated billing codes were “rarely used” by […]