Tag: Healthcare providers

ICD-10-CM Guidelines

Updates to the 2020 ICD-10-CM Guidelines

Cliff notes for the FY20 ICD-10-CM Guidelines for Coding and Reporting. EDITOR’S NOTE: Senior healthcare consultant Laurie Johnson reported this story live during Aug. 13 edition of Talk Ten Tuesday. The following is an edited transcript of her reporting. Last week, I announced that the 2020 ICD-10-CM guidelines were finally released on Aug. 6, 2019. I […]
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RPA in Healthcare

Advancements For RPA In Healthcare

Healthcare organizations are increasingly becoming conscious about improving costs as well as the quality of service to consumers. Technology is growing at an unimaginable speed and the impact it has on every sector is unfathomable. A report by Global market insights pegs the growth of the Robotic Process Automation (RPA) market to reach $5bn by […]
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OB CODING

Is It Possible to Make OB Coding Less Complicated?

Just like our patients, proper OB coding and billing for obstetric patients can be…complicated. As a coding instructor and compliance auditor, I field a lot of questions from new students and experienced billers alike. In this article, I’ll break down a few of the most important concepts you need to understand to master obstetric coding. […]
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Artificial Intelligence in RCM

How AI Can Create A Massive Competitive Advantage – 4 Financial Applications

Healthcare organizations have a tremendous opportunity to harness artificial intelligence in an area that may not seem flashy but is important nonetheless: revenue cycle management. Although 94 percent of companies firmly believe AI can give healthcare organizations a “massive competitive advantage,” according to Change Healthcare’s Adam Sullivan, PhD, less than 5 percent have extensively incorporated […]
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hhs-requests-hold-its-surprise-billing-appeal

Surprise Billing Fight Escalates As Providers Win Arbitration Add To House Bill

The House Energy and Commerce Committee passed the No Surprises Act with a provider-backed amendment adding an arbitration clause Wednesday afternoon. It will now head to the full House for consideration. Dive Brief: The House Energy and Commerce Committee is planning to add third-party arbitration to its surprise billing legislation, the No Surprises Act, on […]
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outpatient Medicare claims

CMS Delays OPPS Claim Edits For Off-Campus Provider-Based Depts

OPPS claim edits slated to take effect this month will now start in October to give providers more take to adjust to billing changes for off-campus provider-based departments. CMS is postponing the implementation of outpatient prospective payment system (OPPS) claim edits that would require hospitals and health systems with multiple locations to list provider addresses […]
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Chronic Care Management

How To Deliver Effective And Profitable Chronic Care Management

Chronic care management (CCM) has an overarching clinical goal—improving the health of Medicare patients with multiple chronic conditions. Besides knowing the service parameters, pay rates and usage requirements for CCM codes, physicians must understand how to effectively bill for CCM in order to profitably achieve that goal. Medicare pays for CCM (typically, non-face-to-face) services to […]
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Medicare Advantage

Medicare Advantage And The Future Of Value-Based Care

The Medicare Advantage (MA) program, which allows Medicare beneficiaries to voluntarily enroll in a private plan that administers health benefits, was established by the Balanced Budget Act (BBA) of 1997 as a vehicle to bring private-sector competition and innovation to Medicare beneficiaries. When the program was announced, the goal was to create greater competition on […]
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