Medical Billing Blog: Section - Medical Billing
Archive of all Articles in the Medical Billing Section
This is the archive containing links to all articles written in the Medical Billing 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.
RCM tip of the day: Start by starting
When seeking to improve revenue cycle management, healthcare organizations should develop a specific plan for each initiative, according to Jim Denny, president and CEO of Navicure. Mr. Denny shared the following tip with Becker’s Hospital Review. “Despite new and ongoing revenue cycle burdens, the real key to making improvements is to start by starting. I always remind our clients to develop a list of needed initiatives for the current year, as well as upcoming years, and approach one or only a few top priority initiatives at a time. For example, if your organization’s days in accounts receivable are through the roof, start by leveraging a data analytics tool to understand …
How to Collaborate for EHR Usability
The number of health IT developers and products has increased significantly as a result of federal incentives for EHR adoption but correlates with the rise of provider dissatisfaction with the usability of these systems. What providers expect from their EHR systems and what health IT developers deliver have proved not to be one in the same. This disconnect points to the need for the latter to focus on the needs of the former and deliver EHR technology that is user-centered. Therefore, collaboration between health IT developers and clinical end-users is key to ensuring EHR systems are user-friendly in an industry rapidly adopting new technologies year after year to tackle new …
Configuring a chargemaster for medical services
Configuring a chargemaster for medical services is like constructing a building. The more complex the building (or medical services), the more planning, skill, and manpower needed to do the job. The chargemaster of a primary hospital will be different from a tertiary hospital with more acute specialty services. The volume of services rendered gives an estimate of the volume of chargemaster transactions, while the variety and complexity of services rendered gives an idea of the resources needed. Dedicated training, level of expertise, attention to details, and the skill of the chargemaster team determine a successful outcome. The Basics 1. Know your payers and its policies (i.e. what Medicare Jurisdiction the …
Incident-to Coding: Physician vs. Non-physician Provider
Question: Our practice needs to make sure that “incident-to” guidelines are being followed? Part of the Medicare guidelines is that the physician must stay involved in the patient’s care, but they don’t give a specific timeframe. If the patient only sees the non-physician provider (NPP) once or twice a year, and only sees the physician every two to three years, would Medicare consider that as the provider staying involved in the patient’s care? Answer: Once upon a time… Continue reading this article
View provider enrollment as a critical part of your RCM
Provider enrollment with payers is crucial, as it ensures proper reimbursement for services rendered, according to Patrick Doyle, senior vice president of Newport Credentialing Solutions. Mr. Doyle shared the following tip with Becker’s Hospital Review: “To ensure every collectible dollar is received, provider enrollment must become an integral part of the revenue cycle process. Best practices should include regular payer audits to validate provider participation status, rigorous payer application follow up, monitoring of licenses and expiring documents, Council for Affordable Quality Healthcare re-attestations and re-enrollments. Furthermore, understand your at-risk revenue against your open enrollments. These are charges billed by providers when their enrollment status is in-process. In-process enrollments for payers …
2018 ICD-10-PCS Code Changes
The U.S. Department of Health & Human Services (HHS) has released the code changes for ICD-10-PCS coding system. ICD-10-PCS codes were adopted under HIPAA for hospital inpatient healthcare settings to use for reporting procedures. Their guidelines help healthcare providers and coders to accurately identify procedures to be reported on healthcare claims. The 2018 updates will reflect services from Oct. 1, 2017 through Sept. 30, 2018, so be sure to update your medical records to account for the changes. There were 75,789 codes in 2017. In 2018, the number jumps to 78,705… Continue reading this article
EHR Data Helps Scientists Detect Heart Failure Earlier
Joint research between IBM Research and Sutter Health led to the development of methods for predicting heart failure using clues imbedded in patient records in Epic EHR technology. Researchers observed the performance of machine learning models designed to detect prediagnostic heart failure in primary care patients using longitudinal data in EpicCare EHRs. “Information that can be gained on populations of patients from longitudinal EHR data can be used to individualize care for a given patient,” Ng et al. stated. “Access to these data in combination with the rapid evolution of modern machine learning and data mining techniques offers a potentially promising means to accelerate discoveries that can be readily translated …
EHR is Still a Top Buying Priority for Physicians
A recent survey of healthcare executives shows that inpatient and outpatient EHR technology are top of mind for provider buying priorities for health IT purchases, trailing only telemedicine. A third of 248 respondents to a Research Data survey listed telemedicine (33%), inpatient EHR (32%), and outpatient EHR (32%) solutions as their current top health IT buying priorities. The three technologies were well ahead of MACRA implementation and patient engagement, both reported by 20 percent of healthcare executives, as health IT purchasing priorities. The greatest number of respondents — ranging from healthcare CEOs, CIOs, and CFOs to IT, medical, and nursing directors — working in standalone hospitals (47%) and integrated delivery …
RCM tip: MACRA calls for a cross-departmental effort
Healthcare organizations should seek cross-departmental collaboration in preparing to manage and execute Medicare Access and CHIP Reauthorization Act initiatives, according to Joncé Smith, vice president of revenue cycle management at Stoltenberg Consulting. Ms. Smith shared the following tip with Becker’s Hospital Review. “Although many may see the IT department as the owner of an initiative like MACRA, true progress can only be achieved from a cross-departmental collaboration among financial, clinical and IT departments. Financial leaders serving on this committee should be responsible for managing the organization’s reporting path, including working with clinical leaders to select the appropriate program measures under either the APM or MIPS track. After all, these program …
Medicare is Still Behind on Telehealth
Medicare has long been criticized for its narrow restrictions on the coverage and reimbursement of telehealth services. A new report to Congress by the US Government Accountability Office (GAO) shows that not much has changed over the years. Mandated by the Medicare Access and CHIP Reauthorization Act, the GAO report noted that Medicare and the US Department of Defense (DoD) trailed the Veterans Affairs (VA) system in their use of telehealth and remote patient monitoring (RPM). On the other hand, the report painted an optimistic picture of Medicare demonstrations and new care delivery models that, it said, might increase the use of telehealth in Medicare. But Gary Capistrant, chief policy …
