Category: Blog

13 New Laboratory Codes – Updates & Changes By CMS

Clinical diagnostic laboratories can look forward to 12 new laboratory codes were effective April 1 and one code effective retroactively January 1. The Centers for Medicare and Medicate Services (CMS) released the changes May 5, 2018. The new codes are contractor priced until addressed at the annual Clinical Laboratory Public Meeting in July. All the […]
13 New Laboratory Codes

13 New Laboratory Codes – Updates & Changes By CMS

Clinical diagnostic laboratories can look forward to 12 new laboratory codes were effective April 1 and one code effective retroactively January 1. The Centers for Medicare and Medicate Services (CMS) released the changes May 5, 2018. The new codes are contractor priced until addressed at the annual Clinical Laboratory Public Meeting in July. All the […]

CMS Gives 213 Hospitals Highest Rating For Patient Experience

Brief: CMS’ latest update to its Hospital Compare website gives 213 hospitals top star ratings for patient experience, according to the Advisory Board.  The agency updated the website on April 25, posting new HCAHPS summary star ratings for 3,466 U.S. hospitals. The three-year-old program rates hospitals on 11 publicly reported measures in HCAHPS surveys, which […]
Adapting Risk Adjustment Coding

Understanding Risk-Adjusted Payment Methodology

The importance of an effective outpatient CDI program cannot be overstated We all know that getting the most accurate and appropriate documentation has always been an issue. Trying to clarify documentation to obtain the most accurate diagnosis coding has expanded to more and more areas, moving from inpatients with DRGs to outpatient with APCs, and […]

CMS Proposes Patient-Driven Pay for Skilled Nursing Facilities

Skilled nursing facilities could face a new Medicare reimbursement system that pays based on patient conditions and needs, rather than volume of services provided. CMS recently proposed updates to several post-acute care prospective payment systems, with skilled nursing facilities seeing a potentially new Medicare reimbursement arrangement, called the Patient Driven Payment Model. The Patient Driven […]

Medicare Reimbursement Cut For Stand-Alone Emergency Departments

Medpac Suggests Cutting Medicare Reimbursement For Stand-alone Emergency Departments The Medicare Payment Advisory Commission (MedPAC) recently voted to reduce Medicare reimbursement by 30 percent for off-campus stand-alone emergency departments (ED) in urban areas. The recommendation will be included in the commission’s June 2018 report to Congress. MedPAC expressed concerns that stand-alone EDs in urban areas resulted in […]

EHR’s To Drive Federal Health IT Spending To $8.1B By 2023

Dive Brief:​ Spending on vendor-provided federal health IT goods and services is estimated to increase from $6.1 billion this year to $8.1 billion in 2023, according to a Health IT News summary of a market outlook report. That increase will largely be driven by EHR projects at the Department of Defense and Veterans Affairs. Spending will top […]

3 Tips To Take Your Denial Management Process To The Next Level

In the dynamic realm of medical billing, the persistence of denied claims poses a significant challenge for providers. Research indicates that an alarming portion of claims – exceeding 10% – face initial denial by insurance companies. This leads to revenue loss, wasted administrative efforts, and frustration for both providers and patients. A robust denial management […]