Medical Billing Blog: Section - Claims
Archive of all Articles in the Claims Section
This is the archive containing links to all articles written in the Claims section of our blog.
Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.
Anthem-Cigna deal could improve competition
Three judges heard appellate arguments from Anthem on March 24, as the insurer pled its case against a district court’s ruling blocking its merger with Cigna, Bloomberg BNA reports. Here are four takeaways from the hearing. 1. One judge in the U.S. Court of Appeals for the District of Columbia Circuit said if Indianapolis-based Anthem’s merger with Bloomfield, Conn.-based Cigna led to $2.4 billion in medical cost savings for consumers, as the insurer has argued, it could be beneficial. “That seems like an improvement in competition and consumer welfare,” U.S. Circuit Judge Brett Kavanaugh said, according to the report. Anthem has said a merger with Cigna would allow the resulting …
Study examines mobile technology use in U.S. hospitals
HIMSS Analytics has released its most recent 2017 Essentials Brief: Mobile Study, which provides an overview of the current use of mobile technology – specifically smart phones and tablets – in U.S. hospitals. Essential Briefs are market research studies focused on identifying salient topics in the healthcare IT space that highlight mind share, market share and market opportunity of specific healthcare software technologies. Health IT researchers from HIMSS Analytics examined the strengths and weaknesses of mobile technology use by U.S. healthcare organizations. To uncover areas that have the most promise for the healthcare market, participants were asked to provide thoughts on future needs to ensure further integration of smartphone/tablet mobile …
7 things to know about medical coding and billing specialists
Medical coding and billing specialists are an integral part of hospitals’ and health systems’ efforts to optimize revenue cycle management processes. Here are seven things to know about medical coding and billing specialists. 1. Medical coders are tasked with reviewing clinical documentation and designating standard codes using ICD-10 classifications. Medical billers primarily process and make sure claims are sent to payers for reimbursement of services administered by a provider, the American Academy of Professional Coders states. 2. A hospital or a health system may combine the responsibilities of coding and billing into a single department, or may divide coding and billing operations into two separate branches. AAPC states if the …
7 Things Your Governance Agreement Must Include
A governance agreement forms the foundation of how a practice’s board of directors is comprised, how it makes decisions and operates, and how it maintains authority. An effective agreement can get a practice through a partner disagreement, financial crisis, legal issue, or natural disaster. It’s a critical document no matter if your group has two or 200 physicians. Most practice governance agreements fall short on detail. Often they contain just the legal statements about board size and voting that are required to file the organization’s corporate documents. Add strength to yours by making sure it includes these seven essentials… Continue reading the full article on Physicians Practice
Many EHR Vendors and Providers Block Information Exchange
Half of electronic health record (EHR) vendors and a quarter of hospitals and health systems routinely engage in information blocking that restricts data flow between providers with different EHRs, according to officials of public health information exchanges (HIEs) surveyed by researchers at the University of Michigan. The top motivation for EHR developers was revenue maximization, whereas the hospital systems were mainly motivated by a desire to maintain or enhance their competitive position, the authors state. The study was published online March 7 in the Milbank Quarterly. In a report issued 2 years ago, the Office of the National Coordinator for Health IT (ONC) said there was anecdotal evidence showing that …
HIPAA Certified: Not So Fast
A healthcare organization is looking for a new electronic medical record, secure messaging application or any other solution. It compares a number of vendors, product features and gets close to choosing one. Just before making the ultimate decision, someone asks, what about HIPAA? As this question enters the discussion, another person says that the chosen product is HIPAA “certified.” Hearing that the product is certified, everyone is satisfied and thinks that HIPAA obligations are all set. Unfortunately, HIPAA “certification” does not settle any issue. The question of certification is one that has been around almost as long as HIPAA itself. From the legal perspective, certification is not even worth the …
20 stats for EHR adoption rates
Less than a decade ago, nine out of ten doctors in the U.S. updated their patients’ records by hand and stored them in color-coded files. By the end of 2017, approximately 90% of office-based physicians nationwide will be using electronic health records (EHRs). Health records are changing quickly — here’s a snapshot of the current EHR landscape: Support for EHR adoption The annual healthcare spending of the country reached ~$2.9 trillion in 2011. It’s expected to soar to $3.5 trillion by 2015. Medical errors cost $19.5 billion a year, and maybe as much as $1 trillion a year when accounting for lost productivity. Medical errors are the third leading cause of death …
