The introduction of 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19) in the United States has produced an influx of patients into the health care system. While knowing how to diagnose and treat these patients is vital, being able to appropriately capture this information for data tracking and payment also is important. The National Center for Healthcare Statistics has […]
Doctors are fond of complaining that they didn’t go to medical school in order to practice business, but independent physicians do spend much of their time on their practices’ finances. That requires mastering revenue cycle management (RCM), the financial process practices use to administer all the functions associated with claims processing, payment, and revenue generation. […]
Certain HIPAA sanctions and penalties are being waived for hospitals during the nationwide emergency concerning COVID-19. Which Privacy Rule Provisions Are Waived? Effective March 15, 2020, covered hospitals will not be held to comply with the following provisions of the HIPAA Privacy Rule: The requirements to obtain a patient’s agreement to speak with family members […]
The 2019-2020 influenza season is winding down, so now is a good time to start preparing for the 2020-2021 influenza season. Let’s start with a new CPT® code for the flu vaccine. Flu Activity Report The Centers for Disease Control and Prevention (CDC) reports that viral activity is decreasing in the United States. According to […]
Denials, automation, and surprise billing are perennially tricky & common revenue cycle issues, but new twists on those topics add an extra layer of complexity. When it comes to revenue cycle management, a handful of common revenue cycle issues are nearly always a struggle, year after year. For instance, denials, automation, and surprise billing are […]
CMS has released several fact sheets in recent weeks on billing and coding to provide guidance to healthcare organizations testing and treating patients for COVID-19, the disease caused by the novel coronavirus. Seven things to know: CMS developed Healthcare Common Procedure Coding System code U0001 to allow laboratories and healthcare providers to bill for using the CDC’s […]
COVID-19 is creating unique healthcare revenue cycle challenges around billing and coding, patient financial responsibility, and resource allocation. As entire nations encourage their populations to stay inside to avoid COVID-19, healthcare providers are more active than ever in response to the outbreak of the novel coronavirus. This activity is having a significant impact on the […]
On Dec. 31, 2019, as many of us here in the U.S. were celebrating New Year’s Eve, a pandemic quietly began in the Chinese province of Hubei. First identified in Wuhan, the provincial capital, coronavirus (more accurately known as COVID-19 or 2019-nCoV) has spread rapidly in the two ensuing months, resulting in infections, and even […]
CMS is proposing changes and a three year extension to the Comprehensive Care for Joint Replacement Model (CJR), which provides a flat set of payments to hospitals for an episode of care through 90 days past patient discharge. The program was due to expire at the end of this year. The agency also wants to include outpatient […]
For the past several decades, patients, providers, and payers have lamented the health of the U.S. healthcare system. Just this past fall, JAMA: The Journal of the American Medical Association, estimated that close to 30% of healthcare spending in the U.S. “may be considered waste.”1 Over these same several decades, an important technology — artificial intelligence […]