Tag: Revenue Cycle Management

Coding “Separate Procedures:” What Coders Need to Know

“Separate procedure” may not mean what you think. Many procedural codes in the CPT® Book are designated as “separate procedures.” However, the common misinterpretation of this is that coders can report such codes as such in every case. Not true. First, you must consider: Were there other procedures performed during the same encounter? Did you consult […]
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To Increase Patient Satisfaction, Providers Need to Start Talking About Costs: Survey

Even as health systems confront rising healthcare costs and declining margins, they are under pressure to improve the patient experience, retain customer loyalty and collect patient payments. But while two-thirds of patients said cost strongly influences their overall satisfaction with their hospital or physician, nearly 60% of health systems do not discuss costs with patients, […]
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MACRA Readiness for Healthcare Organizations

Without even putting too much effort into listening to or reading the news, you understand that healthcare costs have steadily risen over the last couple decades, and yet we don’t really have any significant and correlating rise in outcomes to show for it.  CMS or the Centers for Medicare and Medicaid Services has also noticed […]
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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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Why Hospitals Without Robust Revenue Cycle Support are Losing Millions?

A frequent knock on electronic health records (EHRs) has been that they’re just glorified billing systems that fail to provide enough clinical functionality to make a significant difference in the 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 don’t have an effective […]
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Are Chargemasters Making Medical Billing More Transparent?

When it comes to a trip to the hospital we all know costs can add up quickly, but do you really know exactly what you’re paying for? Well, since January 1, a federal regulation has required hospitals to post machine-readable documents detailing everything they charge for called chargemasters. Though a debate has been raised into […]
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Full MACRA Implementation Needed to Advance Value-Based Care

Failing to execute full MACRA implementation by excluding over half of providers is impeding the transition to value-based care, the industry group told Congress. AMGA is urging Congress to enforce MACRA implementation as policymakers intended by no longer excluding providers from the Merit-Based Payment Incentive Program (MIPS). “MIPS was designed as a viable transition tool […]
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CMS Eliminates Reporting of Functional Limitation Codes

  CMS also has updated its therapy manuals, making elimination of FLR official. Many therapy providers, at hospital outpatient departments and private-practice clinics alike, were reluctant to stop submitting functional limitation reporting codes and impairment modifiers until they could see the guidance clearly written in black and white in the associated therapy policy manuals. While […]
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AHIMA Coding Productivity Study and Preparing for ICD-11

  Planning is underway now for ICD-11. The American Health Information Management Association (AHIMA) has been getting involved in the development of ICD-11 through its participation in the World Health Organization’s (WHO’s) activities, as well as providing members with high-level overviews of what to expect with the new classification system. ICD-11 has yet to be […]
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Ensure Proper MIPS Payment Adjustments with a Targeted Review

Right out of the gate, Medicare Incentive-based Payment System (MIPS) adjustments were incorrectly applied to non physician services and supplies. This error is being corrected by the Centers for Medicare & Medicaid Services (CMS), but what if no one caught it? MIPS eligible clinicians and clinician groups could have improperly lost or gained considerable revenue. […]
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