Category: Blog

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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New ICD-10-CM Code Rationales

New ICD-10-CM Code Rationales

Rationales for ICD-10-CM updates are key to improved medical coding, data reporting, and physician reimbursement. Many of the ICD-10-CM updates for 2020, presented at the ICD-10 Coordination and Maintenance Committee meeting on Sept. 11-12, 2018, provide insight into the purpose of subsequent code changes, which can help you to use the updated code set more […]
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How Hospitals, Health Systems Should Approach Blockchain

How Hospitals, Health Systems Should Approach Blockchain

Pradeep Goel is the CEO of Solve. Care, a healthcare platform aimed at redefining care coordination. Recently, Solve.Care has made partnerships with healthcare organizations to implement it’s healthcare technology in the market. With more than 25 years of healthcare experience, Mr. Goel understands the demands of patients and providers. Below, Mr. Goel discusses how blockchain […]
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The Coding Conundrum Vaping-Related Lung Injury

The Coding Conundrum: Vaping-Related Lung Injury

Confusion persists for the coding of vaping. The Centers for Disease Control and Prevention (CDC) is currently investigating vaping-related illnesses that have recently been reported. There are 450 confirmed or suspected cases in 33 states. The first death was reported on Aug. 23, 2019, in Illinois. The concern has escalated to the point that the […]
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Hospitals to Assume Risk in Value-Based Care Models

Verma Presses Hospitals to Assume Risk in Value-Based Care Models

Hospitals assuming downside financial risk under value-based care models is the key to lowering healthcare costs and improving quality, CMS believes. CMS Administrator Seema Verma urged hospitals on Tuesday to accept new value-based care models and price transparency requirements or face greater administrative burden, less competition, and lower reimbursement rates under Medicare for All. “Our choices are […]
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What Happens When EM Guidelines Change

What Happens When E/M Guidelines Change?

Medical coders, billers, auditors, and other healthcare business professionals started Day 2 of AAPC’s Regional Conference in New York City getting the scoop on the proposed changes to evaluation and management (E/M) services coding and E/M guidelines. E/M Guidelines Changes Are About Time Conference attendees were eager to hear Raemarie Jimenez, CPC, CDEO, CIC, CPB, CPMA, […]
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Coding CAR T Cancer Treatment Revolutionized

Coding CAR T: Cancer Treatment Revolutionized

Now that revolutionary cancer therapy, Chimeric Antigen Receptor T-cell (CAR T-cell), is covered, let’s take a look coding CAR T. Last month the Centers for Medicare & Medicaid Services (CMS) finalized the long-sought rules for coverage of CAR-T, novel cutting-edge, often curative treatments that utilize the patients’ own genetically modified immune cells to fight cancer. The […]
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How Health Systems Improved Revenue Cycle Performance

Tools, Automation and Bots: How Health Systems Improved Revenue Cycle Performance

Improving revenue cycle performance has become more challenging amid today’s healthcare payment trends and patient financial expectations. To gauge efforts at hospitals and health systems, Becker’s Hospital Review asked healthcare leaders to share changes their organizations have made to improve revenue cycle performance this year. Read their responses below, presented alphabetically. Venkat Bhamidipati Executive vice president and […]
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