Category: Blog

U.S. hospitals that are putting quality over quantity will fare well next year for their efforts. Out of  approximately 2,800 hospitals across the country, more than 1,550 will see an increase in their 2019 Medicare payments. For the rest? Well, the news isn’t so good. Where Does The Money Come From? The Centers for Medicare […]

Three more states voted in this previous election to expand Medicaid. Virginia will be going forward with Medicaid expansion on January 1, 2019. Though Medicaid reimburses you at a very low rate, they will pay more than most self-pay patients and the cost to collect is much lower. The payer mix shifting from uninsured to […]

The Trump administration plans to allow states to direct billions of dollars of Obamacare subsidies to health plans that don’t meet the law’s requirements. Critics contend the new policy could undermine the ACA by driving up costs for some individuals. The change is intended to make insurance more affordable and expand consumer choice. Premiums for […]

Are there “Zs” in your spinal fusion coding? The fiscal year (FY) 2019 ICD-10-PCS updated an area that has not received much attention: Spinal fusion codes. During the Centers for Medicare & Medicaid Services (CMS) Coordination and Maintenance Committee meeting in September 2017, the topic of invalid spinal fusion codes was raised. There were spinal […]

CMS is teasing a new cross-industry challenge to identify innovative strategies for using artificial intelligence to improve health outcomes. The CMS Innovation Center is gearing up to launch a new industry challenge aimed at identifying new strategies for leveraging artificial intelligence and machine learning to improve outcomes. The proposed challenge will explore how artificial intelligence […]

When it comes to artificial Intelligence and machine learning, most often we hear them discussed in a clinical context. But that’s not the only realm where AI and ML could make an impact. In fact, revenue cycle is well-suited to AI and MI. According to Nick Giannasi, chief AI officer for Change Healthcare, it’s almost […]

Three experts on revenue cycle and operations at ASCs gathered at the Becker’s ASC 25th Annual Meeting: The Business and Operations of ASCs conference in Chicago Oct. 19 to discuss how administrators can improve reimbursement per case at their facilities. Here are three pieces of advice they shared on how to avoid claims denials: Be […]

Imagine buying a plane ticket, but the fare only covers your seat, the fuel, the gate attendant, and the peanuts. You have to pay the pilot separately. You are sitting on the plane and, unbeknownst to you, the pilot scheduled to fly your plane is delayed and a pilot from another airline takes over. Because […]

For 2019 and 2020, we will see no changes to our outpatient, office-based evaluation and management (E&M) services, but things will change come 2021 – that according to the E&M Final Rule released Thursday by the Centers for Medicare & Medicaid Services (CMS). Since 2004, CMS has stated through the Claims Processing Manual that medical […]

Over the last few years, healthcare has shifted from a standardized, product-centric experience to one that is more personalized. Patients now have access to more information on providers than ever, meaning they have more choice when selecting care they feel will best meet their unique needs. At the same time, patients are taking on more […]