Category: Blog

CMS Releases Final OPPS Rule

CMS Releases Final OPPS Rule For 2018: 8 Things To Know

CMS has released its final 2018 Medicare Outpatient Prospective Payment System rule, which cuts payments to hospitals under the 340B Drug Pricing Program and authorizes Medicare to reimburse for knee replacement surgeries performed in outpatient facilities. Here are eight things to know about the 1,133-page final rule. Payment Update: CMS will increase OPPS rates by […]
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Blue Shield to Require Electronic Claim Submission

On October 26, Blue Shield of California notified physicians that for new or renewing provider agreements for 2018, it will begin requiring practices to submit their claims electronically. All claims, with the exception of those with an accompanying medical record, will be required to be submitted via electronic data interchange (EDI). A complete list of […]
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5 Common Remark Codes For The CO16 Denial

5 Common Remark Codes For The CO16 Denial

co16 denial code description: The CO16 denial code is used in medical billing to indicate that a claim has been denied because it lacks necessary information or contains errors. It falls under the category of “Contractual Obligation” (CO) denials, which means the responsibility falls on the provider to fix the issue and resubmit the claim. […]
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10 Revenue Cycle Tips For Healthcare Organizations

10 Revenue Cycle Tips For Healthcare Organizations

As patients take on more out-of-pocket costs, and patient satisfaction continues to influence the financial health of hospitals, revenue cycle management has become increasingly important to organizations. Amid these and other changes, many revenue cycle professionals have offered thought-provoking insights. Here are 10 RCM tips from industry experts: 1. “To make sure that your organization […]
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5 Ways to Make the Most of Your Coverage

5 Ways to Make the Most of Your Coverage

Now that you have health coverage, here is what you can do to put your health first and live a long and healthy life. 1. Confirm your coverage 2. Know where to go for answers 3. Find a provider 4. Make an appointment 5. Fill your prescriptions 1. Confirm your coverage: Be sure your enrollment […]
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Protecting the Patient’s Right to Privacy

Protecting the Patient’s Right to Privacy

One of the most basic rights that a patient has is the right to privacy. Patients have the right to decide to whom, when, and what extent their private individually identifiable health information is disclosed. This information includes but is not limited to medical diagnosis, treatment plans, prescriptions, health insurance information, genetic information, clinical research […]
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