Tag: Healthcare providers

False-Claims-Act-Allegations

An EHR Vendor to Pay $45M to Resolve False Claims Act Allegations

The U.S. Department of Justice alleges that the EHR vendor accepted and provided “unlawful remuneration in exchange for referrals and by causing its users to report inaccurate information in connection with claims for federal incentive payments.” A developer of electronic health record technology has agreed to pay $45 million to resolve allegations that it violated […]
Learn More
Execution-of-Healthcare-Process

How Processes are Really Executed in Healthcare?

In today’s healthcare ecosystem, every health system, hospital and physician is being asked to do more with less. Healthcare providers face increasing pressure to manage revenue, optimize utilization and reduce costs. At the same time, they must also fulfill their primary duties: preventing illness, optimizing care and improving patient outcomes. From clinical decision support systems […]
Learn More
ED-ICU-Model-Improves-Value-of-Healthcare-Delivery

ED-ICU Model Improves Value of Healthcare Delivery

The ED-ICU model has the potential to improve the value of healthcare delivery, as it has been shown to improve care quality and have little impact on emergency department costs. Total cost per emergency department (ED) patient encounter remained unchanged at an academic medical center after it implemented an emergency department-based intensive care unit (ED-ICU), […]
Learn More
Intricacies-of-the-2021-EM-Coding-Guidelines

Intricacies of the 2021 E/M Coding Guidelines

Industry experts explain the intricacies of the 2021 E/M coding guidelines. During the Evaluation and Management (E/M) Panel general session, an expert panel made up of a physician, coder, auditor, payer, and a representative from the American Medical Association (AMA) answered audience questions regarding the 2021 E/M coding guidelines for office/outpatient visits. The panelists were […]
Learn More
Healthcare-Price-Transparency

60% of Consumers seek Healthcare Price Transparency

A survey shows that 60% of consumers who look for pricing information seek answers from their insurance companies, but healthcare price transparency should still be a priority for providers. Not many consumers are asking how much healthcare services cost but among those who do, they are seeking answers primarily from their insurance companies, according to […]
Learn More
the-challenges-of-billing-observation-correctly

The Challenges of Billing Observation Correctly

Observation, outpatient outlier payments, and the Inpatient-only List: Getting it right is not always easy. On this week’s Monitor Mondays we had a robust discussion about Condition Code 44. And on June 9, I will be presenting a webinar on the nebulous concept of “outpatient” service in a bed. Both of these have one thing […]
Learn More
the-past-present-and-future-of-em-services

The Past, Present, and Future of E&M Services

Providers are currently stuck with outdated templates, leaving plenty of room for improvement. I thought it might be appropriate to take a “four score and seven years ago” look across evaluation and management (E&M) services, looking at what we had, what we have, and what is still to come. So, to begin, I will rewind […]
Learn More
x