Tips for improving outpatient billing, coding and CDI. In moving from inpatient clinical documentation improvement (CDI) to outpatient CDI, I have been discovering some unique educational pointers. I know we are all very busy, so let’s just dive right into it. Doctors and coders, you should not have diagnoses that are mutually exclusive to one […]
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 […]
A comprehensive hospital claim validation strategy that prevents denials and improves efficiencies hinges on the right blend of retrospective and pre-bill reviews. The time to strengthen hospital compliance programs through claim validation is now. According to healthcare finance and information management leaders surveyed by HIMSS Media, clinical documentation and coding were the revenue cycle processes most vulnerable […]
A 2016 study in the Annals of Internal Medicine found that for every hour physicians spend in direct face-to-face clinical time with patients, they spend nearly two additional hours on desk work. According to the American Academy of Family Physicians (AAFP), this administrative burden is one of the primary complaints of its members, and prior authorizations top the list of […]
Allzone Management Services, a leading provider of healthcare management services, announced its participation in the Raintree Systems User Conference 2019, an entire conference is centered around deep and meaningful ENGAGEment with users through highly focused workshops, feedback sessions, and industry speakers. The Conference takes place this October 08-12, 2019 at Boston Park Plaza, Boston, Massachusetts. […]
In the crowded healthcare market, smart healthcare leaders must find patient satisfaction advantages everywhere they can. When it comes to patient satisfaction, providing excellent clinical care is a no-brainer. But in a crowded and competitive healthcare market, smart healthcare leaders know that they need an edge everywhere, including an efficient revenue cycle. That’s the case […]
4 Strategies For Accurate Medical Coding and Denial Prevention Payers typically deny evaluation and management codes (E/M code) on the back end of the billing process, which can cause costly reimbursement recoupments, according to Medical Economics. Four tips to avoid denials caused by inaccurate E/M levels: Make sure the E/M code supports the specific patient encounter. […]
It’s every physician’s worst nightmare: Receive payment for services rendered, but then a payer identifies an aberrant pattern in claims data, audits the records, decides it has overpaid the practice, and recoups those funds. That money you already allocated for overhead, staff salaries, bonuses, or new medical equipment? Gone. With one post-payment audit, you now […]
An overwhelming majority (92 percent) of patients want to know their payment responsibility prior to visit. This statistic, from InstaMed’s seventh Trends in Healthcare Payments Report, highlights the recent shift in patient financial engagement. Patients have become consumers who seek transparency and flexibility when paying for healthcare expenditures. However, medical groups are lagging when it comes to meeting […]
OPPS claim edits slated to take effect this month will now start in October to give providers more take to adjust to billing changes for off-campus provider-based departments. CMS is postponing the implementation of outpatient prospective payment system (OPPS) claim edits that would require hospitals and health systems with multiple locations to list provider addresses […]