Category: Blog

Denials Management v Denials Avoidance

Denials Management Versus Denials Avoidance: CDI Can Capitalize

  Typical CDI programs are intended to drive reimbursement through diagnosis securement, contributing to improved case mix index. The COVID-19 pandemic is placing monumental financial stressors upon hospitals, with added costs to treat patients with high acuity and long length of stays, coupled with significant revenue loss associated with postponement of more profitable elective surgeries, […]
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Clinical Documentation Improvement Vendors

Clinical Documentation Improvement Vendors Gaining Momentum

The clinical documentation improvement (CDI) vendor landscape has undergone significant changes over the last couple of years, including vendor acquisitions and technology developments. And these changes and other factors have had an impact on customer experience, according to a recent KLAS report. For example, vendors like Iodine, Optum, and 3M have gained momentum over the past […]
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Advanced Technology for Reimbursement

Advanced Technology Will Help Drive Reimbursement Change

Telehealth, remote monitoring will boost patient outcomes and value-based care results Limited by the slow pace of change in traditional reimbursement models, shifts in the paradigm for patient care have also lagged far behind the possibilities created by transformative technology. The COVID-19 pandemic has changed that, catalyzing improvements in reimbursement by both commercial and government […]
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Telehealth Cybersecurity

Industry Voices – How To Tackle Telehealth Cybersecurity Threats

  Many healthcare organizations quickly adopted telehealth programs out of necessity at the start of the COVID-19 pandemic, expanding their attack surface with the integration of new technology such as mobile telehealth apps and wearable heart rate and blood glucose level monitors. What’s more, nearly half of security researchers (48%) believe the healthcare industry is […]
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Medicare Coverage Rule

CMS Releases Highly Anticipated Medicare “Breakthrough” Coverage Final Rule

The final rule also clarifies the definition of “reasonable and necessary.” On Jan. 14, the Centers for Medicare & Medicaid Services (CMS) published a final rule creating a new Medicare coverage and reimbursement pathway for “breakthrough” medical devices. Durable medical equipment (DME) providers and long-term care facilities (LTCFs) and hospitals that render DME services, read on! Medical device […]
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Medicaid Physician Reimbursement Rates

Medicaid Physician Reimbursement Rates Lag Medicare

Medicaid physician reimbursement rates in the fee-for-service part of the program were about 72% of Medicare rates for the same service, a new study finds. Medicaid physician reimbursement is significantly lower than commercial payer and even Medicare payments for the same services despite growing enrollment in the public healthcare program, reveals a new Urban Institute study. […]
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Health System empowers communities

The Role of Health Systems in Empowering Communities

  With all that has happened over the past year, from the coronavirus pandemic to ongoing social justice movements, healthcare workers and organizations are standing in solidarity with their communities like never before. While these corresponding pandemics emphasize the need for healthcare organizations to empower the communities they serve, they also highlight the necessity to […]
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NCTAP Coding and Billing

CMS Clarifies Coding and Billing for NCTAP

The NCTAP was finalized as part of CMS’ fourth COVID-19 interim final rule. CMS on January 27 updated coding and billing instructions to hospitals for new COVID-19 treatments add-on payment (NCTAP). The NCTAP was finalized as part of CMS’ fourth COVID-19 interim final rule with comment period (IFC-4) and is effective November 2, 2020 through the end of the public health […]
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