Tag: Healthcare Management Services

Coding “Separate Procedures:” What Coders Need to Know

“Separate procedure” may not mean what you think. Many procedural codes in the CPT® Book are designated as “separate procedures.” However, the common misinterpretation of this is that coders can report such codes as such in every case. Not true. First, you must consider: Were there other procedures performed during the same encounter? Did you consult […]
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To Increase Patient Satisfaction, Providers Need to Start Talking About Costs: Survey

Even as health systems confront rising healthcare costs and declining margins, they are under pressure to improve the patient experience, retain customer loyalty and collect patient payments. But while two-thirds of patients said cost strongly influences their overall satisfaction with their hospital or physician, nearly 60% of health systems do not discuss costs with patients, […]
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MACRA Readiness for Healthcare Organizations

Without even putting too much effort into listening to or reading the news, you understand that healthcare costs have steadily risen over the last couple decades, and yet we don’t really have any significant and correlating rise in outcomes to show for it.  CMS or the Centers for Medicare and Medicaid Services has also noticed […]
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Chronic Conditions: Code or Not to Code MCCs

Understanding the correct use of chronic condition codes in the coding process. Unexpected and inaccurate medical bills can be alarming and shocking. Coders are often confused regarding when they should code co-morbid chronic conditions and when they should not. This leads to inaccurate coding of levels, or sometimes missing out on the opportunity of stressing […]
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How to Avoid and Correct Inaccurate Medical Bills

Unexpected and inaccurate medical bills can be alarming and shocking. Whether it’s hundreds or tens of thousands of dollars, when you get a bill for an ER visit or surgery you already paid or don’t owe, it can sometimes be difficult to get answers from the provider or insurance company. All this week KPRC2 consumer […]
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Why Hospitals Without Robust Revenue Cycle Support are Losing Millions?

A frequent knock on electronic health records (EHRs) has been that they’re just glorified billing systems that fail to provide enough clinical functionality to make a significant difference in the quality of care. So it’s somewhat incongruous that a recent Black Book report on revenue cycle management (RCM) system adoption would say that 26 percent of hospitals don’t have an effective […]
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Are Chargemasters Making Medical Billing More Transparent?

When it comes to a trip to the hospital we all know costs can add up quickly, but do you really know exactly what you’re paying for? Well, since January 1, a federal regulation has required hospitals to post machine-readable documents detailing everything they charge for called chargemasters. Though a debate has been raised into […]
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Full MACRA Implementation Needed to Advance Value-Based Care

Failing to execute full MACRA implementation by excluding over half of providers is impeding the transition to value-based care, the industry group told Congress. AMGA is urging Congress to enforce MACRA implementation as policymakers intended by no longer excluding providers from the Merit-Based Payment Incentive Program (MIPS). “MIPS was designed as a viable transition tool […]
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Robotic Process Automation in Healthcare Will Lead to Better Patient Outcomes

Robotic process automation in healthcare:  Software bots represent a powerful digital workforce that can work tirelessly in the background supporting doctors and administrators, says Henry Xie, is the CEO and founder at Simple Fractal Since the Affordable Health Care Act was passed in 2010, the number of adults with health insurance has increased by more than […]
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CMS Eliminates Reporting of Functional Limitation Codes

CMS also has updated its therapy manuals, making elimination of FLR official. Many therapy providers, at hospital outpatient departments and private-practice clinics alike, were reluctant to stop submitting functional limitation reporting codes and impairment modifiers until they could see the guidance clearly written in black and white in the associated therapy policy manuals. While the […]
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