Category: Blog

Spinal Fusion Codes

ICD-10 Coding: New Character Surfaces in Spinal Fusion Codes

Are there “Zs” in your spinal fusion coding? The fiscal year (FY) 2019 ICD-10-PCS updated an area that has not received much attention: Spinal fusion codes. During the Centers for Medicare & Medicaid Services (CMS) Coordination and Maintenance Committee meeting in September 2017, the topic of invalid spinal fusion codes was raised. There were spinal […]
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Artificial Intelligence Health Outcomes Challenge

CMS to Launch Artificial Intelligence Health Outcomes Challenge

CMS is teasing a new cross-industry challenge to identify innovative strategies for using artificial intelligence to improve health outcomes. The CMS Innovation Center is gearing up to launch a new industry challenge aimed at identifying new strategies for leveraging artificial intelligence and machine learning to improve outcomes. The proposed challenge will explore how artificial intelligence […]
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3 Tips To Manage Claims Denials At ASCs

3 Tips To Manage Claims Denials At ASCs

Three experts on revenue cycle and operations at ASCs gathered at the Becker’s ASC 25th Annual Meeting: The Business and Operations of ASCs conference in Chicago Oct. 19 to discuss how administrators can improve reimbursement per case at their facilities. Here are three pieces of advice they shared on how to avoid claims denials: Be […]
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Reimbursement

E&M Flat Rate Reimbursement Delayed to 2021

For 2019 and 2020, we will see no changes to our outpatient, office-based evaluation and management (E&M) services, but things will change come 2021 – that according to the E&M Final Rule released Thursday by the Centers for Medicare & Medicaid Services (CMS). Since 2004, CMS has stated through the Claims Processing Manual that medical […]
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Maximize Collections

5 Ways To Maximize Collections as The Patient Becomes The Payer

Over the last few years, healthcare has shifted from a standardized, product-centric experience to one that is more personalized. Patients now have access to more information on providers than ever, meaning they have more choice when selecting care they feel will best meet their unique needs. At the same time, patients are taking on more […]
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Are Medicare Advantage Plans Creating Excessive Denials

Are Medicare Advantage Plans Creating Excessive Denials?

MAs are taking advantage of excessive denials to reduce payments to providers. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently found that between 2014 and 2016, a total of 75 percent of all appealed Medicare Advantage (MAs) denials were overturned, equivalent to roughly 216,000 denials a year. I […]
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Seven Outcomes of Successful Patient Engagement Strategies

Seven Outcomes of Successful Patient Engagement Strategies

There are numerous patient engagement strategies aimed at improving care. What are the outcomes that show these solutions are working? Patient engagement affects every patient interaction across the care continuum. Accordingly, the outcomes that you can expect will come from every area of the organization. When refining targeted outcomes, let metrics be your guide. Measurement […]
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