Medical billing outsourcing services are services in which a healthcare provider hires a medical billing service provider outside their practice to do all the billing. The main types of services in medical billing outsourcing are the front end and back end. The front-end is in charge of the patient experience, while the back-end is in […]
A thorough understanding of the latest guidelines for coding evaluation and management services is necessary to ensure compliant claims. You’ve likely heard about the 2023 CPT® changes for reporting hospital inpatient and observation evaluation and management (E/M) services. AAPC has been preparing medical coders for these changes since they were announced and started offering education […]
Attendees at AAPC’s AUDITCON, Nov. 3-4, 2022, came loaded with questions about the coding and guideline changes for evaluation and management (E/M) services in CPT® 2023. The conference offered several sessions on the subject, including the ED session, “Changes in 2023: Emergency Department,” presented by AAPC Chief Product Officer. The officer provided a high-level overview […]
Providing care management services, including chronic care management (CCM) and principal care management (PCM), is not easy. The first overarching challenge is that not enough patients actually participate in care management with a primary care physician. In fact, A recent report from the Primary Care Collaborative and the American Academy of Family Physicians’ more Americans […]
E/M, Gastro, and Lab Coders, take note. The American Medical Association (AMA) announced some last-minute corrections to the CPT® code set effective Jan. 1, 2023. Add these to your code book, along with the previously released corrections, to ensure you start the year off right with accurate codes and guidelines. Evaluation and Management (E/M) In […]
Quality metric reporting can be a significant challenge to health care administration due to a number of obstacles. First and foremost, you need buy-in from the physicians providing the care to the patients. Without this, it is difficult to make any meaningful changes to the pattern of care provided. Second, it requires having a very […]
The American Hospital Association (AHA) and Better Medicare Alliance (BMA) both support the agency’s effort to improve Medicare Advantage (MA). In an attempt to reform MA, CMS released a proposed rule that aims to streamline prior authorization, promote health equity, and curb deceptive marketing. The Biden administration has shown a commitment to increasing oversight of […]
Cash is like oxygen for start-ups; founders sometimes take it for granted, but it keeps your business alive. Even if you have a great product, growing revenue, and a steady talent pipeline, your company is dead if you run out of cash. Given the importance of cash, cash management — which includes managing runway and […]
The Center for Medicare & Medicaid Innovation (CMMI) has launched more than 50 alternative payment and care delivery model tests, with 33 models now or still operational, according to CMMI’s sixth report to Congress on its progress. These model tests have impacted the lives of millions of patients. In the two-year period covering the report, […]
Partnering with a vendor that provides EHR and RCM capabilities helped one healthcare organization boost communication and improve revenue cycle efficiency for 150 care centers. Leveraging automation for revenue cycle management (RCM) processes can streamline tasks and improve efficiencies. Specifically, partnering with an EHR vendor helped a healthcare organization to achieve $1 billion in patient […]










