Tag: Healthcare providers

Navigating the Shift: Preparing for the ICD-11 Transition in 2024

Navigating the Shift: Preparing for the ICD-11 Transition in 2024

The healthcare industry is on the verge of a significant transformation as we approach 2024: transitioning from ICD-10 to ICD-11. Healthcare providers, payers, and patients alike will all be impacted by this shift, which promises to revolutionize the way medical diagnoses and treatments are documented and reported. Our comprehensive guide explores the intricacies of ICD-11, […]
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Navigating the Financial Impact of Value-Based Care (VBC)

Navigating the Financial Impact of Value-Based Care (VBC)

The financial impact of VBC is profound, necessitating adjustments in how providers approach and manage their financial operations to align with this new model of care. The healthcare industry is shifting towards value-based care (VBC), a model that prioritizes high-quality care while aiming to lower costs. In contrast to the traditional fee-for-service model, value-based care […]
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Unlocking the Secrets of Denied Claims: Insights, Solutions, and Strategies

The Prime Minister’s recent voluntary national survey shed light on the Denied claims. The survey, conducted between October and December 2023, found that nearly 15% of all Medicare Advantage, Medicaid, Commercial and Managed Medicaid claims were denied. Between 45% and 60% of rejected cases were overturned, although the expensive appeals process sometimes meant multiple appeals. […]
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HCPCS Level II Code Updates for April 2024

HCPCS Level II Code Updates for April 2024

The official April 2024 update to the HCPCS Level II code set is now available on the Centers for Medicare & Medicaid Services website.  April update includes: 62 new codes 2 changes to scope and long description 21 obsolete codes 11 changes to long description 1 change to changes miscellaneous changes Below are some  code […]
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7 Strategies to Support Medical Coders Struggling with Quality and Accuracy

7 Strategies to Support Medical Coders Struggling with Quality and Accuracy

Help your medical coders facing difficulties in maintaining coding accuracy by implementing a focused strategy. Medical coders hold a crucial position in healthcare, translating intricate medical data into standardized codes essential for billing, research, and patient treatment. The importance of accurate and high-quality medical coding cannot be overstated, as errors may result in financial setbacks […]
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Understanding ABNs for Providers and Medicare Beneficiaries

Understanding ABNs for Providers and Medicare Beneficiaries

The Advance Beneficiary Notice (ABN), Form CMS-R-131, issued by the Centers for Medicare & Medicaid Services (CMS), holds immense importance for healthcare providers, revenue cycle teams, and Medicare beneficiaries. What is an ABN (Advance Beneficiary Notice)? An ABN, formally extended to Medicare Fee-for-Service (FFS) beneficiaries, precedes outpatient services like labs, imaging, physical therapy, or observation. […]
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Four Common Forms of Virtual Care Reimbursed in Half of US States

Four Common Forms of Virtual Care Reimbursed in Half of US States

According to a recent report, 25 states now provide reimbursement for video, store-and-forward, and audio-only telehealth, as well as remote patient monitoring through Medicaid. Although every state and Washington, D.C. include some form of live video-based telehealth in their Medicaid programs, only 25 of them also offer Medicaid reimbursement for live video, store-and-forward telehealth, remote […]
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