The hype around Artificial Intelligence (AI) spiked again recently with the public release of ChatGPT. The easy-to-use interface of this natural language chat model makes this AI particularly accessible to the public, allowing people to experience first-hand the potential of AI. This experience has spurred users’ imagination and generated feelings ranging from great excitement to […]
Prevention of readmission denials improves case mix index (CMI), reimbursement, and quality metrics. As a consultant, I am like the FBI – if you invite me in, I will likely take your case. This often leads to varied and challenging projects. Often, I am engaged to assess opportunity in provider documentation, clinical documentation integrity (CDI) […]
Using this technology to create the discharge summary is that the output is only as good as the input. A physician advisor once had a terribly unfortunate incident in which a pregnant patient died. This initiated a mandatory investigation by the Ohio Department of Health (ODH). This was one of those imperfect storms in which […]
The average health system saw 110,000 claim denials due to prior authorization and other factors in 2022, a recent study says. KEY TAKEAWAYS: Revenue cycle leaders are placing denials management at the top of the list of areas to improve for 2023. Denials rose to 11% of all claims last year, up nearly 8% from […]
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, […]
More than half of patients are concerned about the quality of care they’re receiving, according to the Software Advice survey. One of the firm’s analysts dives into the results. Telemedicine has, at long last, become very popular. But lingering concerns remain on its effectiveness for certain diagnoses and treatments. Software Advice’s 2022 State of Telemedicine […]
To understand this dynamic, you need to know who the customer is. One of the key questions arising from looking at financial statements is this: how do we “get to the bottom line” in healthcare? In our society and culture, we have a fascination with the term “net income,” but it may have little meaning […]
Industry experts explain the intricacies of the 2021 E/M coding guidelines. During the Evaluation and Management (E/M) Panel general session, an expert panel made up of a physician, coder, auditor, payer, and a representative from the American Medical Association (AMA) answered audience questions regarding the 2021 E/M coding guidelines for office/outpatient visits. The panelists were […]
Five priorities are identified in the mission of CMS Office of Minority Health, “Working to Achieve Health Equity.” The Centers for Medicare & Medicaid Services (CMS) has five key priority areas that are expected to drive how the agency will, within a span of 10 years, accomplish its stated goal to achieve health equity. Priority […]
Total expenses for hospitals and physician practices were up 7 percent compared to June 2021. Hospitals, health systems, and physician practices saw rising revenues and patient volumes in June 2022, but it was not enough to offset the continuously high expenses, leading to negative margins for the sixth consecutive month, according to data from Kaufman […]










