Category: Blog

Sedation Coding

Moderate Sedation Coding

Moderate sedation coding, also sometimes referred to as conscious sedation, is a drug-induced depression of consciousness. A patient who has been sedated in this way is relaxed and generally insensitive to pain, but remains awake and able to respond to verbal instruction. If medically necessary and properly documented, moderate sedation is a separately reported service. […]
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Medicare Quality & Cost

Better Quality, Lower Health Care Costs – Providers & Payers Share Risk

Denied claims are one of physicians’ chief complaints when it comes to dealing with payers. To a certain extent, every practice deals with claim denials. It’s those practices that eliminate the most common reasons that experience a smoother revenue cycle and find greater financial success. News Brief A capitation payment model results in better value […]
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Top 13 Reasons For Claim Denials

Top 13 Reasons For Claim Denials

Denied claims are one of physicians’ chief complaints when it comes to dealing with payers. To a certain extent, every practice deals with claim denials. It’s those practices that eliminate the most common reasons that experience a smoother revenue cycle and find greater financial success. Here are the 13 most common reasons for why claims […]
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CMS Posts 2020 IRF Proposed Rule

The focus on electronic health record implementation has turned to how to make use of the vast data stored within to improve revenue cycle operations (IRF). Proposed rule calls amending regulations clarifying the determination as to whether a physician qualifies as a rehabilitation physician is made by the IRF. The Centers for Medicare & Medicaid […]
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Three Ways to Facilitate Better Decision-Making with Claims Automation

Suggestions for conducting peer-to-peer appeals for denials management. Claims Automation has been a part of the workers’ compensation and auto casualty industries for years, but today, a large opportunity still remains to increase in the claims automation process. The future of automation in the Property and Casualty industry is not to replace jobs but instead […]
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Allzone - PEER-TO-PEER APPEALS

A Rebeginner’s Guide to Peer-to-Peer Appeals

Suggestions for conducting peer-to-peer appeals for denials. If you are wondering why you should read this if you think you are not a rebeginner, well, it is because you actually are one. Beginnings do not disappear, they just reproduce. Novices are just starting, veterans have started over and over. We all begin as beginners and […]
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What Providers Need to Know Right Now About PDPM

The Centers for Medicare & Medicaid Services’ Patient-Driven Payment Model (PDPM) takes effect on Oct. 1. When the reform takes effect, long-term post-acute care (LTPAC) facilities will see a big change in how they receive payment for delivering valuable patient care. While the payment reform will inevitably bring challenges, it will also present a significant […]
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Urgent Need for New Revenue Streams will Shape Providers Strategies

Building alternative revenue streams source will play a bigger role in healthcare providers’ strategies, according to a new study. Ninety percent of hospital and health system executives surveyed indicated that new revenue streams were an urgent priority expected to yield a return in the next three years, a new study from Boston-based Partners Health Care […]
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AI in Medical Billing

Could AI-Driven Medical Billing be The Key to Keeping Struggling Hospitals in the Black?

The entrepreneurs behind Sift Healthcare are using predictive analytics (AI) to crack the code on unpaid medical bills, helping health facilities work smarter when managing budgets. Last month, Alabama’s Georgiana Medical Center closed its doors, making it the 13th Alabama hospital to close in eight years. Seven of the 13 shuttered hospitals served rural communities. In […]
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