The Centers for Medicare & Medicaid Services (CMS) knows that a significant amount of money is being overpaid to insurance companies in the Medicare Advantage program, but they have yet to recover these overpayments. That’s about to change. CMS says it will increase the audits being performed on Medicare Advantage risk-adjusted code submissions and apply […]
Blockchain technology continues to cause a significant amount of disruption in various industries across the world, particularly in healthcare, according to a Research and Markets report. Three things to know: The decentralized ledger technology has the potential to overcome interoperability and security challenges that have plagued the healthcare system. Within the healthcare segment, technology is being used […]
Healthcare organizations are increasingly becoming conscious about improving costs as well as the quality of service to consumers. Technology is growing at an unimaginable speed and the impact it has on every sector is unfathomable. A report by Global market insights pegs the growth of the Robotic Process Automation (RPA) market to reach $5bn by […]
Healthcare organizations have a tremendous opportunity to harness artificial intelligence in an area that may not seem flashy but is important nonetheless: revenue cycle management. Although 94 percent of companies firmly believe AI can give healthcare organizations a “massive competitive advantage,” according to Change Healthcare’s Adam Sullivan, PhD, less than 5 percent have extensively incorporated […]
Electronic medical records (EMR) introduced a new era of healthcare management. Should healthcare operators want to venture farther, they may need to consider digitizing their internal operations, as well. Hospitals and clinics present extremely complex environments to manage. There is little wonder that manual and piecemeal approaches to everyday operations are no longer sufficient. Many […]
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 […]
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 […]
Over my almost 30-year surgical coding career, the documentation for assistant surgeons consisted of only the name of the assistant surgeon in the operative note header. Most often there was no mention of the role of the assistant surgeon in the body of the operative note; it was assumed the assistant surgeon provided an extra […]
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 […]
CAQH CORE, a healthcare industry-led operating standards group, has announced new rules that move the healthcare industry closer to fully automating the prior authorization process. “Not only do the operating rules represent a foundational step forward in improving the prior authorization process, they also signal broad industry commitment to adopting tangible solutions to reduce administrative burdens,” said […]