Tag: Healthcare Services

the-changing-landscape-of-healthcare-b2b-payment-transactions

The Changing Landscape of Healthcare B2B Payment Transactions

Healthcare B2B payment transactions have been high in 2021, potentially signaling the importance of electronic payment transfers as the nation emerges from the coronavirus pandemic, according to a report from National Automated Clearing House Association (NACHA). Nacha oversees the ACH Network, a national payment system. B2B payments made through this network in the healthcare industry […]
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lack-of-healthcare-interoperability-hinders-electronic-aco-reporting

Lack of Healthcare Interoperability Hinders Electronic ACO Reporting

CMS is looking to modernize the ACO reporting process by mandating the use of electronic clinical quality measures (eCQMs). However, accountable care organizations (ACOs) are concerned that the lack of healthcare interoperability will make electronic ACO reporting near impossible. “CMS must avoid making eCQMs mandatory until standard data fields exist across EHRs, and true interoperability […]
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aha-pens-oppositions-to-2022-physician-fee-schedule-proposed-rule

AHA Pens Oppositions to 2022 Physician Fee Schedule Proposed Rule

The organization is concerned about policies in the 2022 Physician Fee Schedule proposed rule, ranging from telehealth worries to apprehension about MIPS. The AHA agreed with certain aspects of the rule but also voiced various problems and recommendations for CMS to consider. The AHA opposed several telehealth policies that CMS included in the rule. The […]
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cms-repeals-rule-allowing-coverage-breakthrough-technologies-medicare-patients

The CMS repeals rule allowing coverage of breakthrough technologies for Medicare patients

CMS is exploring a new rule due to concerns raised and operational challenges. The rule that would have allowed access to Food and Drug Administration-designated and -approved technologies for Medicare patients suffering from illnesses and conditions that existing treatments and technologies are unable to address. CMS is exploring a new rule due to concerns raised […]
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payer-extends-medicare-advantage-footprint-to-reach-5m-seniors

Payer Extends Medicare Advantage Footprint to Reach 5M Seniors

SCAN Health Plan will offer its senior-first Medicare Advantage Plans in 17 markets across three states starting in 2022. SCAN currently provides senior-focused Medicare Advantage plans to 220,000 Californians and aims to reach even more seniors by extending its offerings to Alameda and San Mateo counties. The payer had not offered plans in states other […]
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covid-19-aha-ahima-faq-revisions-made

COVID-19 AHA/AHIMA FAQ Revisions Made

  The implication of an incorrect COVID-19 diagnosis can be profound. I made a mistake last week. I was told that the joint American Hospital Association/American Health Information Management Association (AHA/AHIMA) frequently asked questions (FAQ) regarding ICD-10-CM coding for COVID-19 had been updated, so I checked the website (https://www.codingclinicadvisor.com/faqs-icd-10-cm-coding-covid-19). On the introduction page, it stated, […]
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5 Steps To Revenue Cycle Succession Planning Success

It’s more important than ever for revenue cycle leaders to think seriously about succession planning as baby boomers begin to retire and the revenue cycle increasingly requires more specialized skills, says PeaceHealth’s senior enterprise director of HIM, coding, and CDI. “Everyone’s replaceable,” says Cassi Birnbaum, senior enterprise director of HIM, coding, and CDI at PeaceHealth […]
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cms-to-tie-vaccine-mandate-to-medicaid-medicare-participation

CMS to Tie Vaccine Mandate to Medicaid, Medicare Participation

  A COVID-19 vaccine mandate for healthcare workers will be tied to Medicaid and Medicare Conditions of Participation (CoP), the Biden-Harris Administration recently announced. The announcement made via CMS yesterday said the Administration will require COVID-19 vaccination of staff in all Medicaid and Medicare-certified facilities by October. The emergency regulation, when it is released, will […]
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top-3-member-engagement-benefits-of-using-omnichannel-tools

Top 3 Member Engagement Benefits of Using Omnichannel Tools

Omnichannel strategies are becoming increasingly significant to successful member engagement. What is omnichannel engagement? Omnichannel engagement is a strategy that originated as a sales and marketing term but has infiltrated various sectors of the healthcare industry with the rise of healthcare consumerism. This strategy involves using various consumer touchpoints to push a product in a […]
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how-ambulatory-surgery-centers-lower-payer-outpatient-spending

How Ambulatory Surgery Centers Lower Payer Outpatient Spending

Payers can reduce surgical costs by 59 percent by shifting eligible members from the hospital outpatient setting to ambulatory surgery centers. Ambulatory surgery centers are care sites that offer surgical procedures, diagnostics, and preventive care services, according to the Ambulatory Surgery Center Association. These sites are not provider offices, rural healthcare clinics, or urgent or […]
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