Tag: Patient Care

Boost reimbursement through improved documentation

Boost reimbursement through improved documentation

Five tips to ensure better documentation and, along with it, better patient care and improved reimbursement. Providers and coders need a cooperative relationship, working toward a common goal of complete coding and positive reimbursement results, as supported by medical documentation. Here are five tips to ensure better documentation and, along with it, better patient care […]
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CMS Issues Long-Awaited, Controversial Final Rule on Price Transparency

CMS Issues Long-Awaited, Controversial Final Rule on Price Transparency

  A long-awaited and controversial final rule on healthcare price transparency was released Thursday by the federal government. The rule, mandated under a June 2019 executive order by President Donald Trump, requires private group health plans and individual health insurance market plans to disclose pricing and cost-sharing information in a consumer-friendly format. The mandate, which takes effect on January […]
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Billing and Documentation Guide for Patient Care During COVID-19 Pandemic

Billing and Documentation Guide for Patient Care During COVID-19 Pandemic

  The COVID-19 pandemic has brought about robust changes to the traditional practice of healthcare in the United States. In a time of social distancing and widespread quarantining, regulatory bodies, including the Centers for Medicare & Medicaid Services (CMS), have adapted to the current environment. The most critical goal was to allow healthcare providers to […]
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“Defensive” Undercoding Is Indefensible

“Defensive” Undercoding Is Indefensible

Undercoding, or reporting a lesser service than was performed and documented, is sometimes employed as a defensive strategy to stave off claims denials or audits. But, undercoding can make a provider an outlier, and may create consequential patient care, compliance, and financial liabilities. For example: Undercoding Leaves Money On The Table, Driving Down Provider Reimbursement […]
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Chronic Condition

Chronic Conditions: Code or Not to Code MCCs

  Understanding the correct use of chronic condition codes in the coding process. Unexpected and inaccurate medical bills can be alarming and shocking. Coders are often confused regarding when they should code co-morbid chronic conditions and when they should not. This leads to inaccurate coding of levels, or sometimes missing out on the opportunity of […]
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