The U.S. healthcare industry has a $1 trillion opportunity to cut costs and reduce waste, according to a 2015 Harvard Business Review analysis. While there are various areas waste accumulates, costly data reconciliation is a prominent problem for hospitals and health systems. Change Healthcare defines data reconciliation as “the process of compiling information across companies […]
America’s Health Insurance Plans called on Congress to set a fixed reimbursement rate based on what insurers pay in a region. Providers are pushing back against an insurer proposal for legislation to set reimbursement rates to avoid surprise medical bills. In a letter to Senate and House leaders this week, America’s Health Insurance Plans and 16 other […]
Data security is now one of the top aspects of healthcare technology. It can make or break patient satisfaction and institutional reputation. Healthcare providers have a professional obligation not only to care for their patients’ health but also to protect their patients’ data. Cyber crime is on the rise against the sector because healthcare providers […]
Most industries embrace the motto “the customer is king.” They are acutely aware their success is driven by it. While the complexity of the healthcare business model has made it challenging for provider organizations to adopt such an ethos, the recent rise of consumerism in the industry necessitates that providers prioritize the patient experience if […]
The CPT® codes that are considered a laboratory test under the Clinical Laboratory Improvement Amendments (CLIA) change each year, as well as throughout the year, making it difficult for healthcare providers and laboratories to keep up. Here are the CPT codes for 2019 that are subject to or excluded from CLIA edits in easy-to-look up […]
The importance of Artificial Intelligence (AI) in Medical Coding is often understated and also overstating the same is quite difficult.. to get in-depth with how AI is actually bringing changes in MCA, we must get to the basics of what Medical Billing and Coding really are. Medical Coding Medical coding, if we talk about it […]
Every business not only wants to attract new customers but to keep its existing ones, and hospitals and health systems are no different. Unfortunately, surprise medical bills can be the element that drives patients away from one hospital and into the waiting arms of the competition. New research published this month in Health Affairs provides hospitals with […]
The Centers for Medicare & Medicaid Services (CMS) issued a policy change modification to the claims processing logic for Modifier 59 Distinct procedural service (and the optional patient-relationship modifiers XE, XS, XP, and XU) on February 15, 2019. These modifiers are only processed when applied to the Column 2 code in a bundled pair, per Correct Coding Initiative […]
A frequent knock on electronic health records has been that they’re just glorified billing systems that fail to provide enough clinical functionality to make a significant difference in quality of care. So it’s somewhat incongruous that a recent Black Book report on revenue cycle management (RCM) system adoption would say that 26 percent of hospitals […]
Technology can transform data into actionable insights for providers needing to meet the demands of value-based care and consumerism in healthcare. Transforming raw data into actionable information is crucial to the financial future of provider organizations, especially as pressure builds on providers to align their care delivery approach with value-based care and consumerism in healthcare. […]