Category: Revenue Cycle Management

Denials Management Versus Denials Avoidance_ CDI Can Capitalize

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 Gaining Momentum

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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Industry Voices – How To Tackle Telehealth Cybersecurity Threats

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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Medicaid Physician Reimbursement Rates Lag Medicare

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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Understanding 2021 Changes in Emergency Medicine Reimbursement

Understanding 2021 Changes in Emergency Medicine Reimbursement

  Emergency medicine groups face several changes this year, including a new federal ban on surprise medical billing, updates to the Medicare reimbursement formula, changes to the CMS MIPS program, and new billable services. Below is a summary of these changes provided by the experts at Brault Practice Solutions. Federal Ban on Surprise Medical Billing […]
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The Importance of Data Security in Medical Facilities

  Today, data breaches, ransomware attacks, and identity theft are endangering privacy and well-being. This is true for medical data because if malicious hackers get access to it, human lives and health could be at stake. Scammers may also attempt to benefit from ongoing events to disrupt the data gathering process for healthcare corporations. Medical […]
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Digital Health in 2021_ 5 Strategies to Transform Care & Conquer Adoption Barriers

Digital Health in 2021: 5 Strategies to Transform Care & Conquer Adoption Barriers

The uptake of telehealth services during the COVID-19 pandemic has shone a spotlight on the use of digital technologies in healthcare. Telehealth platforms have connected patients and clinicians remotely, but telehealth’s growth has obscured a broader movement that had already been underway for some time:  the use of digital health to transform care. Advances in […]
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CMS to Reprocess Some Outpatient Claims After Site-Neutral Ruling

CMS to Reprocess Some Outpatient Claims After Site-Neutral Ruling

CMS has announced that it will reprocess hospital outpatient claims from last year for clinic visit services provided at excepted off-campus provider-based departments. The agency will start reprocessing the claims in July 2021 in order to pay all hospitals the same rate as non-excepted off-campus provider-based departments for clinic visit services paid under the Physician Fee Schedule, […]
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Health IT Predictions for 2021_ What Awaits Post-Pandemic

Health IT Predictions for 2021: What Awaits Post-Pandemic

One year ago, it’s doubtful that anyone could have accurately predicted the changes that would occur in healthcare in 2020. While facing the world’s greatest health crisis in living memory, we’ve seen amazing shifts in adapted care delivery and a surge in “telemedicine,” as well as implementation, regulation, coding, and payment adjustments established at great […]
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