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.
5 Common Reasons for Medical Claim Denials
“When a patient’s insurance claim is denied, not only can your cash flow be affected, the relationship with your patient can be damaged as well. Some claim denials can be successfully appealed, but even when appeals succeed, they can temporarily leave claim status up in the air – something both your practice and your patient would like to avoid. Understanding common reasons for claim denials is key to preventing them. The insurers your practice works with may offer software tools to help you prevent claim rejections (which are claims that aren’t processed due to clerical errors) and claim denials (where claims are considered, but payment is denied) so it’s important …
HHS Finalizes Strategies to Combat EHR Clinician Burden
“Divisions of HHS worked together to develop strategies for addressing the four main causes of clinician burden stemming from EHR use. The Department of Health and Human Services (HHS) published a set of strategies, Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, aimed at combating health IT-related burdens on healthcare providers. The report fulfills a provision in the 21st Century Cures Act requiring HHS, the Office of the National Coordinator (ONC), and the Centers for Medicare and Medicaid Services (CMS) to produce a report for Congress on the strategies and recommendations to aid this overwhelming epidemic. Clinician burden is primarily linked to …
What does a study of medical coders reveal about Artificial Intelligence?
“Greater attention to human factors and new techniques may change the way artificial intelligence is trained with small data, according to an article published by Harvard Business Review. Researchers from Accenture wanted to see if opportunities lay within smaller data sets that go unused by organizations. For their study, the researchers focused on annotations added to medical charts by medical coders. With their tens of annotations on each of several thousand charts, the annotations are much smaller compared to data sets with a billion columns and rows. In the experiment, the coders studied RNs who regularly used AI in their coding processes to link medical conditions with proper codes. The …
EHR Usability Issues Increase After Implementation and Optimization
“Most believe EHR usability issues happen at implementation. However, the majority of EHR usability problems occur after implementation when the EHR is continuously optimized, according to a study published in the BMC Medical Informatics and Decision Making. “Implementation of the EHR is not limited to a single event in time,” wrote the researchers. “Rather, the technology changes when newer features are added, or interfaces are redesigned. These upgrades may improve functionality, but they also require physicians to adapt to changes beyond the initial implementation.” “Users are required to continually learn how to use the newer system and then to incorporate these upgrades into their clinical workflow, often with negative work …
Billing quality is medical quality – 5 physician-backed metrics to consider
“New billing measures could help providers give their patients a quality billing experience, which two physicians argued in JAMA is a type of medical quality. In a viewpoint article, Simon Mathews, MD, and Martin Makary, MD, of the Johns Hopkins University School of Medicine in Baltimore, offered five metrics providers could use to measure whether patients are receiving a quality billing experience. Here are the five metrics: 1. Itemized bills: Are patients always given an itemized bill that explains charges in simple language? 2. Price transparency: Can patients get real prices for shoppable, elective services? 3. Service quality: Are billing representatives available to promptly speak with patients about any concerns …
3 EHR Usability and Optimization Fixes That Address Burnout
“There are many positives associated with EHRs. However, EHR usability is a common negative among EHR users, which leads to clinician burnout. As the calendar flips to 2020, technological advancements in the EHR are key to addressing this epidemic that makes its way around medical facilities throughout the country. According to a study completed in a partnership between the Mayo Clinic and the American Medical Association (AMA), researchers found that EHR usability was largely graded an “F” when evaluated on a traditional letter grade scale, and that failing grade was strongly tied to high clinician burnout scores. “A new study issued today found electronic medical records (EHRs) – as currently …
21 ICD-10-CM codes deleted for FY 2020
CMS has provided ICD-10-CM coding updates for fiscal year 2020 that include 273 additions 21 deletions and 30 revisions, according to the American Health Information Management Association. The 21 deletions for the fiscal year beginning Oct. 1, 2019, and ending Sept. 30: 1. D813 Adenosine deaminase [ADA] deficiency 2. H8141 Vertigo of central origin, right ear 3. H8142 Vertigo of central origin, left ear 4. H8143 Vertigo of central origin, bilateral 5. H8149 Vertigo of central origin, unspecified ear 6. I481 Persistent atrial fibrillation 7. I482 Chronic atrial fibrillation 8. Q660 Congenital talipes equinovarus 9. Q661 Congenital talipes calcaneovarus 10. Q6621 Congenital metatarsus primus varus 11. Q6622 Congenital …
Teaching Doctors Have a New Way to Document E/M
Rules are changed for teaching physicians documenting Evaluation and Management (E/M) codes being reported to Medicare July 29, 2019. These changes are part of the Center for Medicare & Medicaid Services’ (CMS) revamp of E/M payments. This will affect medical coders and billers, especially those working in clinical documentation improvement. Changes Part of E/M Revamp Effort The change relaxes the long-standing requirement that teaching physicians re-document information documented by residents and the medical team. This is part of CMS’ response to physicians and facilities’ request to simplify documentation and E/M decision making in general following nation-wide meetings. It also allows teaching physicians to join their non-teaching peers in …
9 Ways to Improve Health IT Interoperability and Patient Data Access
“The Healthcare Leadership Council (HLC) and the Bipartisan Policy Center recently issued a report outlining nine ways the public and private sector can work together to advance health IT interoperability and improve patient data access. Many recommendations included in the report align with newly-released proposed rules from CMS and ONC intended to crack down on information blocking. The report incorporates feedback from more than 100 clinicians and healthcare leaders from hospitals, health systems, health plans, life sciences organizations, health IT companies, and patients gathered in a year-long effort. The report aims to streamline the flow of health information across health IT systems and care settings. “Critical patient information is getting …
Return on Investment in Healthcare
Professor William A. Hyman has a good article on ROI over at Hitech Answers… “The usual meaning of Return on Investment (ROI) in purely financial transactions is how much money do you get back for the amount of money you put in. It is usually desirable for the amount returned to exceed the amount invested, thus achieving a positive ROI. In healthcare this concept requires modification because of who may receive the benefit and whether or not that benefit is monetary. Here our concern is usually investments in IT, although there are many other possibilities such as medical devices. In some hospital “investments” there can be an internal positive return …
