Tag: Healthcare

Value based payment

Value-Based Payment: Prioritizing Patient Health Over Profits

Value-Based Payment: Putting Patient Health First: When recommending a medical procedure, should doctors prioritize insurance reimbursements or patient health? The answer hinges on the payment model. In a fee-for-service system, providers are compensated for each individual service, potentially incentivizing excessive care. This model can lead to increased costs and harm patients through unnecessary treatments or medications. […]
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TEAM: CMS’s New Value-Based Payment for Surgeries

The Centers for Medicare & Medicaid Services (CMS) is introducing a new way to pay for specific surgical procedures: Transforming Episode Accountability Model (TEAM). This mandatory model, starting January 1, 2026, will hold hospitals accountable for the cost and quality of care for 30 days after five types of surgeries: Lower extremity joint replacement Surgical […]
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Top Strategies to Prevent Medical Billing and Coding Errors

Medical coding and billing errors are a persistent headache for healthcare providers, costing them time, money, and reputation. Studies show that a staggering percentage of medical bills contain errors, leading to denied claims, delayed payments, and frustrated patients. Focus on Prevention: Top coding and billing Errors to Avoid Non-Covered Charges: Verify insurance coverage before rendering […]
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Streamline Prior Authorizations and Reduce Stress for Your Patients

Streamline Prior authorizations can be a real pain, but with a few adjustments, you can make the process smoother and save yourself and your patients some stress. Here are 5 tips to streamline prior authorizations: Know Your Triggers: Become familiar with medications and procedures that frequently require prior authorization. Identify alternative options, like generics, that […]
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medical-coding-compliance-strategy-to-reimbursement

3 Coding Compliance Strategies to Improve Reimbursement, Quality

The Crucial Role of Medical Coding Compliance in a Value-Based World: Telling the Patient’s Story for Better Billing and Quality Care. Medical Coders: The Unsung Storytellers of Healthcare Medical coders play a critical role in hospitals, but their importance often goes unnoticed. They’re the storytellers behind the scenes, analyzing patient records, selecting billing codes, and […]
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Telehealth Compliance 10 Things You Need to Know

Telehealth Compliance: 10 Things You Need to Know

Telemedicine or telehealth, which refers to providing care via electronic communication when patients and providers are in separate locations, has been available for decades. However, the COVID-19 pandemic has accelerated the adoption of telehealth due to the urgent need to deliver care in new ways. Before the pandemic, telehealth faced challenges such as limited reimbursement, […]
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New ICD-11 Codes

The New ICD-11 Codes: What You Need to Know

 In the ever-evolving field of healthcare, accurate diagnosis and effective treatment depend on a universal coding system that provides a common language for medical professionals worldwide. The International Classification of Diseases (ICD) serves as the backbone of this system, and with the recent transition to ICD-11, a new era of coding has begun. In this […]
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Patient Care Advancement

5 Medical Advances That Changes Patient Care’s Future

Every day, scientists strive to solve some of medicine’s toughest questions. Here’s a look at recent breakthroughs that tackle painful conditions and deadly diseases. Gene sequencing at record speeds to identify dangerous mutations. A treatment that delays Type 1 diabetes for years. A vaccine to prevent RSV infections, which kill thousands of Americans each year. […]
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Top Trends Of Revenue Cycle In 2023

Healthcare providers before reeling down the effect of the extended period of misfortune due to COVID-19 were additionally affected by pretentious impact and rising cost of healthcare supplies. RCM leaders are currently focused on two central themes: safeguarding their revenue and maximizing efficiency with limited resources. Unfortunately, the effects of the great resignation have resulted […]
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