Earlier this month, CMS announced changes to future payments for Medicare Advantage plans that will take effect in 2020. While a pay raise is part of the plan, what’s causing a stir is that payment will now be based on a higher percentage of patient encounter data (up to 25% from 10%). Many (especially payers) have argued that encounter data is often incomplete and inaccurate when compared to diagnoses, since encounter data relies on provider documentation.
Read MoreTags: Medical Coding, Remote Medical Coding, Coding Accuracy
Administration of vaccines is an important part of healthcare delivery, and a critical contribution to preventive public healthcare. However, risings costs are making it difficult to align vaccine administration expenses with revenues.
There may be some relief to these rising costs and it comes from something that was once seen as a burden for medical practices. That relief comes in the form of ICD-10 coding.
Read MoreTags: ICD-10, Revenue Cycle Management (RCM), Medical Coding, outsourced medical coding, outsourced coding, coding outsourcing, Medical Coding BPO, RCM Solutions
The Centers for Medicare & Medicaid Services’ (CMS) grace period for denials of claims under ICD-10 will end on October 1, 2016. Healthcare providers and billing companies must be prepared for this deadline and its financial effects.
Read MoreTags: Medical Coding, Outsource Coding, Remote Medical Coding, Medical Coding BPO
The Obama administration and health insurers took steps recently to standardize and improve the measures that are intended to gauge the quality of healthcare. The CMS and trade group America's Health Insurance Plans (AHIP) have announced an agreement to adopt a core set of quality measures for the nation's doctors. Officials say the measures are necessary as payers and consumers bear more responsibility for finding and purchasing high-quality care and providers are increasingly paid under contracts tied to their quality performance. This is a good move!
Read MoreTags: Business Process Outsourcing (BPO), HIPAA, Medical Coding, Offshore Medical Coding, Outsource Coding, Medical Coding BPO
By Nitin Thakor, GeBBS President & CEO
So far small hospitals and small health systems are not faring as well as large hospitals and health systems during the ICD-10 transition. The press is full of reports about how well the transition is going for large hospitals, but that is not the case for smaller community hospitals.
Read MoreTags: Business Process Outsourcing (BPO), Revenue Cycle Management (RCM), Healthcare Revenue Billing, Medical Coding, Knowledge Process Outsourcing (KPO), Offshore Medical Billing, Offshore Medical Coding
By Nitin Thakor, GeBBS President & CEO
According to a recent survey reported in Healthcare Finance, 83 percent of hospitals now outsource some accounts receivable and collections, 58 percent of hospitals outsource some contract management, 55 percent of hospitals outsource some denials management and 68 percent of physician groups with more than 10 practitioners now outsource some combination of collections and claims management.
Read MoreTags: Business Process Outsourcing (BPO), Revenue Cycle Management (RCM), Healthcare Revenue Billing, Medical Coding, Knowledge Process Outsourcing (KPO), Offshore Medical Billing, Offshore Medical Coding, Outsource Coding, Offshore Revenue Cycle Management, Healthcare BPO Companies, Medical Coding Outsourcing, Remote Medical Coding
In today’s healthcare environment of shrinking reimbursements, due to governmental mandates and Medicare policy changes, the importance of maintaining a healthy revenue cycle is second only to providing the best patient care possible. Without an adequate margin there can be no medical mission.
Read MoreTags: Business Process Outsourcing (BPO), Revenue Cycle Management (RCM), Medical Coding, Affordable Care Act, Insurance Billing Solutions, Offshore Medical Billing, Offshore Medical Coding, Medical Billing BPO, Offshore Revenue Cycle Management, Remote Medical Coding, Medical Coding BPO
There is an upside to this second delay for ICD-10; we should use this time wisely! There will now be NO excuse for not being prepared in October 2015. This additional window of time presents an opportunity for U.S. healthcare providers to spend this period preparing for the significant impact that ICD-10 will bring. Many healthcare facilities were dreading the October 2014 implementation date; however, there is now time to prepare for the monumental changes this sweeping reform will precipitate.
Tags: ICD-10, Revenue Cycle Management (RCM), Medical Coding
In a recent Modern Healthcare article, long-time IT editor, Joseph Conn, predicted a “rocky” ICD-10 roll-out according to a survey conducted by the magazine. Even though the majority of respondents were optimistic, chaos is the predicted descriptor of the Oct. 1 deadline for nationwide conversion to the ICD-10 codes, according to the survey.
Tags: ICD-10, Revenue Cycle Management (RCM), Medical Coding
Most healthcare providers we talk to are worried (or at least concerned) about severe reductions, or even the complete stoppage, of their revenue streams caused by potential ICD-10 coding errors and slowdowns in their coding workflows – and rightly so! The transition to ICD-10 has the potential to produce a tremendous backlog of insurance claims.
Tags: ICD-10, Clinical Documentation Improvement (CDI), Medical Coding
