Category: Blog

Medicare Advantage And The Future Of Value-Based Care

Medicare Advantage And The Future Of Value-Based Care

The Medicare Advantage (MA) program, which allows Medicare beneficiaries to voluntarily enroll in a private plan that administers health benefits, was established by the Balanced Budget Act (BBA) of 1997 as a vehicle to bring private-sector competition and innovation to Medicare beneficiaries. When the program was announced, the goal was to create greater competition on […]
Learn More
Hundreds of New ICD-10-CM Codes

Hundreds of New ICD-10-CM Codes Effective Oct. 1

The Centers for Medicare & Medicaid Services (CMS) released on June 20 the new ICD-10-CM codes descriptions, tables and index, and addendum for fiscal year 2020. There are 273 additions, 21 deletions, and 30 revisions, effective Oct. 1, 2019, which will increase the code set from 71,932 to 72,184 diagnoses. Chapter Review The majority of changes to new […]
Learn More
AI In Healthcare

AI In Healthcare: Fact Or Fiction?

Patients experienced out-of-pocket increases as high as 12% for their healthcare costs last year, according to a new analysis by TransUnion Healthcare. Technology experts have promised artificial intelligence (AI) and machine learning (ML) will revolutionize healthcare. Applications have the potential to streamline workflows and reduce human errors, speeding drug discovery, assisting surgery, and provisioning better […]
Learn More
A Patient-Centered Approach To Revenue Cycle Tech Strategy

A Patient-Centered Approach To Revenue Cycle Tech Strategy

A strategic approach to patient-centered revenue cycle technology strategy should be enabled by predictive analytics and machine learning to help customize the payment experience, refine communication messages, and give proper feedback to continually improve back-end processes. The path to financial health for hospitals and health systems has shifted and is rematerializing in a way that […]
Learn More
Using Artificial Intelligence To Advance Revenue Cycle Management

Using Artificial Intelligence To Advance Revenue Cycle Management

Artificial intelligence (AI) is making big waves in healthcare from detecting lung cancer and gene mutations that lead to autism to addressing social determinants of health and chronic conditions. The technology is automating and optimizing clinical workflows, leading to improved outcomes, lower costs, and enhanced patient and provider satisfaction. The critical role artificial intelligence now plays in healthcare prompting some providers to […]
Learn More
Blockchain Takes Over The Power to Heal

Blockchain Takes Over The Power to Heal

Blockchain has taken the shape of an important asset in the 21st century with applications starting from practitioner’s authentication to supply chain management. The abilities of the robust privacy and interoperability of blockchain can change the healthcare space and improve the wide range of needs in healthcare. Blockchain provides a reliable and standard chain of […]
Learn More
electronic health record

Is Your EHR Ready For PDGM?

When the Patient-Driven Groupings Model (PDGM) launches Jan. 1, 2020, leveraging tools and resources to ensure compliance will be critical to a successful transition. Home health care providers already have one helpful tool in place: the electronic health record (EHR). By incorporating workflow efficiencies, alerts, customizable features and feedback reporting capabilities, EHRs can provide visibility […]
Learn More
AMA on Evaluation and Management Service Codes Guidelines

AMA on Evaluation and Management Service Codes Guidelines

Medical coders who were unsure what documentation non-Medicare payers would expect in light of the Patients Over Paperwork Initiative now have more to go on. The initiative reduced documentation requirements for outpatient evaluation and management service codes (CPT® 99201-99215) provided to Medicare Part B patients beginning in 2021. The Centers for Medicare & Medicaid Services (CMS) indicated in their initiative that, although […]
Learn More
Medicare Advantage Plan Denials

Medicare Advantage Plan Denials: Is That Convoluted or What?

Medicare Advantage Plan contracts are “take-it-or-leave-it” agreements Many questions are swirling about regarding Medicare Advantage Plan (MAP) denials asking what to do about the increasing number and given reasons.  I’ve heard or read some amazing stories where payers have gone to astounding lengths to deny claims.  Answers are also swirling about based on understandings of […]
Learn More
x