Year: 2019

How To Code EM Levels with Confidence

How To Code E/M Levels with Confidence

How many times has a provider asked you, “What do I need to document to get a 99215?” All too often, medical coders feel they should help their providers understand what elements of documentation are needed to warrant the higher level evaluation and management (E/M) service. Do not do it! If It Isn’t Documented, It […]
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Medicare Retires G Codes for Mammograms

Medicare Retires G Codes for Mammograms

Ensure that your practice’s medical coding for preventive screening mammograms aligns with the most recent guidelines during Breast Cancer Awareness Month in October. Coding Mammograms for Medicare The Centers for Medicare & Medicaid Services (CMS) now acknowledges the CPT® mammogram codes, aligning with industry standards. This streamlines the process for coders to accurately document mammogram […]
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Prevent Billing Errors to Reduce Hospice Claim Denials

Prevent Billing Errors to Reduce Hospice Claim Denials

Effective revenue cycle management can reduce hospice claim denials, particularly those associated with billing or documentation errors. In addition to slowing down payments or losing revenue, submitting inadequate or incomplete required written documentation is a sure-fire way to bring surveyors or auditors to a hospice’s doorstep. As regulators increasingly fix their eyes on the hospice space, providers […]
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AI and EHR Perfect Together

AI and EHR: Perfect Together?

Big data and electronic health records — along with other technologies — could change the way long-term care is delivered. We’re living in an age of unprecedented technology. Back in the 1960s, when most of the residents at your long-term care facility were establishing their careers and rearing children, the first computers began appearing in […]
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Affordable Care Act Plans

Affordable Care Act Plans Will Be Able To Offer Wellness Incentives Under CMS Pilot

Insurers can offer premium discounts or other incentives to engage in healthy activities, but questions remain as to whether wellness programs work. Affordable Care Act plans in 10 states will be able to offer wellness programs, as employer-sponsored plans have been doing for years. The Centers for Medicare and Medicaid Services on Monday announced the opportunity for […]
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Optimizing Revenue Cycle Management

Optimizing Revenue Cycle Management For 2020

With patients seeing higher medical bills than ever and healthcare costs continuing to rise, healthcare organizations need to stay on top of the revenue cycle to ensure they can capture payments and be prepared for changes in 2020. Speaking at the annual meeting of the American Health Information Management Association (AHIMA) in Chicago, Cassi Birnbaum, […]
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CMS Finalizes How It Will Cut Medicaid DSH Payments

CMS Finalizes How It Will Cut Medicaid DSH Payments

The Senate passed a continuing resolution that would temporarily stop the implementation of Medicaid DSH payment cuts until Nov. 22, 2019. CMS on Monday finalized a rule that will reduce Medicaid Disproportionate Share Hospital (DSH) payments by $4 billion next year and $8 billion a year until fiscal year 2025. The new final rule will implement Medicaid DSH payment […]
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Root Causes Linked to Claim Denials

Root Causes Linked to Claim Denials

Three revenue cycle tips are provided to reduce denied claims. Claim denials represent millions of dollars in lost and delayed net reimbursement annually. According to the American Medical Association (AMA), cost estimates of inefficient healthcare claims processing, payment, and reconciliation top out at $210 billion per year. Claim denials are so common, they’ve become a fixture […]
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Hospitals Looking Beyond EHR to Improve Revenue Cycle Performance

Hospitals Looking Beyond EHR to Improve Revenue Cycle Performance

Over 60 percent of hospitals and health systems are not realizing optimal value from their EHR system, causing the organizations to collaborate with other vendors and outsourcing companies to improve revenue cycle performance. That was a finding from a new Navigant analysis based on an executive survey conducted by Healthcare Financial Management Association (HFMA), which polled 108 […]
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