Hospital and health system executives should monitor these proposals for provisions that will affect their organizations’ operations. The 2020 annual rule cycle has been active for CMS. Several proposals in the outpatient prospective payment system (OPPS) proposed rule is controversial, although there is at least one provider-friendly change. Here’s a roundup of five regulatory rules […]
Most healthcare organizations partner with physician services groups for niche coverage. While outsourced medical services are available across all specialties, common areas for external physician support include anesthesia, radiology, wound care, and emergency medicine. However, when outsourced physician services are used, challenges to ensure accurate reimbursement for both components of care—the hospital portion and the […]
EDITOR’S NOTE: Five Looking at Ten is a month-long series on ICD10monitor and Talk Ten Tuesdays that examines lessons learned since the nation’s healthcare system adopted ICD-10 transition – many of which are expected to come into play with the looming transition to ICD-11. George Vancore of Blue Cross Blue Shield of Florida appeared as […]
86% of medical group practices in an MGMA report said regulatory burden rose in the last year, with prior authorizations and the Quality Payment Program adding to that burden. A vast majority of medical group practices experienced growing regulatory burden in the last year, with prior authorizations and Medicare’s Quality Payment Program topping their list […]
Among the many examples of Artificial Intelligence, AI in healthcare is clearly one of the leaders. AI is already reshaping medicine in many ways, and its influence will only increase in the years ahead. To shed light on this major shift, I spoke with Dr. Krishnan Nandabalan, founder and CEO of InveniAI, an AI healthcare company based in Connecticut. We […]
As per new update in medical coding, their will again some new ICD 10 codes in FY 2020. Also, their will some deletion and revision of ICD 10 codes. Their are around 273 new codes, 21 deleted codes, and 30 code title revisions for Year 2020. The new changes are as per the Proposed Inpatient Prospective Payment System (IPPS) […]
How many times has a provider asked you, “What do I need to document to get a 99215?” All too often, medical coders feel they should help their providers understand what elements of documentation are needed to warrant the higher level evaluation and management (E/M) service. Do not do it! If It Isn’t Documented, It […]
Effective revenue cycle management can reduce hospice claim denials, particularly those associated with billing or documentation errors. In addition to slowing down payments or losing revenue, submitting inadequate or incomplete required written documentation is a sure-fire way to bring surveyors or auditors to a hospice’s doorstep. As regulators increasingly fix their eyes on the hospice space, providers […]
With patients seeing higher medical bills than ever and healthcare costs continuing to rise, healthcare organizations need to stay on top of the revenue cycle to ensure they can capture payments and be prepared for changes in 2020. Speaking at the annual meeting of the American Health Information Management Association (AHIMA) in Chicago, Cassi Birnbaum, […]
The Senate passed a continuing resolution that would temporarily stop the implementation of Medicaid DSH payment cuts until Nov. 22, 2019. CMS on Monday finalized a rule that will reduce Medicaid Disproportionate Share Hospital (DSH) payments by $4 billion next year and $8 billion a year until fiscal year 2025. The new final rule will implement Medicaid DSH payment […]