2025 CMS Proposed Rule: Announcing this week a proposed rule for inpatient and long-term care hospitals (LTCHs) for the fiscal year of 2025 (FY), federal officials cited an increasing focus on social determinants of health (SDoH). The Centers for Medicare & Medicaid Services (CMS) also prioritized improving maternal health and strengthening emergency preparedness, which noted […]
Medical coding is a dynamic field, driven as much by technological advancements as by healthcare practices and regulatory changes. As we are moving into 2024, we can see that several important trends are shaping the future of this important field. Future of Medical Coding 2024: 1. Rise of Artificial Intelligence (AI) and Machine Learning (ML) […]
The importance of Revenue Cycle Management (RCM) is no longer just a best practice in today’s ever-changing healthcare landscape – it has become a necessity. In a market where costs are rising, regulations are becoming more complex, and patients are becoming more responsible for their own finances, optimizing the revenue cycle is essential to maintain […]
RCM Challenges : Today’s fast-paced healthcare industry, where rules are always changing and technology is advancing at breakneck speed, can make it challenging to navigate the complexities of medical billing, coding, and revenue cycle management (RCM). In addition to maximizing cash flow and protecting your practice’s financial health, there is also the constant risk of […]
The traditional and conservative realm of healthcare has experienced significant and swift technological upheaval in the last ten years. The surge of generative AI and Large Language Models (LLMs) has outpaced any previous innovation wave, revolutionizing the landscape. While lauded as potential remedies for numerous healthcare challenges, these innovations confront the digital health industry with […]
Alongside its positive impact on health outcomes, the Medicare Advantage value-based care plans implemented by an insurance provider resulted in a significant $8 billion in cost savings throughout 2022. Reports from the payer revealed that Medicare Advantage beneficiaries under value-based care exhibited improved health conditions, marked by reduced inpatient admissions and emergency room visits. The […]
The Senate Finance Committee proposed that the full chamber should review a legislation that could instigate alterations in physician practices. This proposition was discussed during a 90-minute meeting on November 8, 2023, regarding the bill named “The Better Mental Health Care, Lower-Cost Drugs, and Extenders Act.” This bill encompasses diverse aspects of healthcare, including mental […]
Tools and support to boost the success of your practice Regardless of whether you’re a newcomer to private practice or a seasoned professional, you’re aware that the healthcare landscape is ever-changing. What was effective for your practice in the past, be it last year or last month, may not hold true today. Staying updated on […]
In order for value-based healthcare to succeed, it is imperative that physician practices effectively articulate the medical services and procedures they provide. This underscores the vital role of the Current Procedural Terminology (CPT®) code set in driving the shift towards value-based care. According to the chair of the AMA/Specialty Society Relative Value Scale Update Committee (RUC), […]
Prompt payment to healthcare providers for their services is crucial for a detailed discussion on managing macro costs, quality, and equity. Without it, addressing the issue of rising healthcare costs becomes challenging. Healthcare providers are well aware that getting paid is not an easy task. A quick search for revenue cycle management (RCM) reveals 16-step […]