Tag: Healthcare providers

Two New CPT Codes Effective Immediately

News Alert: Two New CPT Codes Effective Immediately

Reimbursement details have not yet been established. The American Medical Association (AMA) CPT® Editorial Panel has made adjustments to one code and introduced two new codes to enhance the specificity of serology laboratory testing. These codes, released on April 10, are immediately applicable. Reimbursement arrangements for the Centers for Medicare & Medicaid Services (CMS) are […]
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Prior Authorization Burden

9 Ways To Ease The Prior Authorization Burden

Prior authorizations, or prior approvals, are strategies that payers use to control costs and ensure their members only receive medically necessary care. The cost-control process requires providers to acquire advance approval from payers before delivering specific services or items for a patient. Payers are increasingly using prior authorizations to lower their costs and improve care […]
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Providers to Focus on Patient Billing

Providers to Focus on Patient Billing, Policy Heading into 2020

In addition to patient billing and policy, healthcare M&A and workforce diversity will also be major trends going into the new year, according to PwC’s Health Research Institute. Patient billing, policy and regulation, healthcare mergers and acquisitions, and workforce diversity will be some of the top priorities for provider organizations in 2020, predicted researchers at PwC’s Health […]
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AI Clinical Documentation Improvement Tools

Providers Ready for AI Clinical Documentation Improvement Tools

88% of providers are eager to implement clinical document improvement technology that leverages AI, and 93% believe the systems can streamline document creation. Forty-four percent of healthcare organizations already use artificial intelligence (AI) in one form or another, and more hospitals are looking to apply the technology to coding and clinical documentation improvement, a recent […]
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Reducing Patient Billing Disputes

How Hospitals Avoid or Reduce Patient Billing Disputes

CMS’ reworked the Merit-based Incentive Payment System, to simplify reporting requirements for providers in its 2020 Physician Fee Schedule Quality Payment Program Final Rule.Patient billing disputes result in more work for hospital staff and can potentially stand in the way of timely payment for services. However, many organizations are making efforts to avoid or reduce […]
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How To Code EM Levels with Confidence

How To Code E/M Levels with Confidence

How many times has a provider asked you, “What do I need to document to get a 99215?” All too often, medical coders feel they should help their providers understand what elements of documentation are needed to warrant the higher level evaluation and management (E/M) service. Do not do it! If It Isn’t Documented, It […]
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