Healthcare’s Wake-up Call for Current Clients in 2013-2014

Our industry is on the eve of confluence among four major technology drivers. When considered as a whole, they may represent the Perfect Storm/Y2K/Tsunami of changes leading to negative impacts on productivity and profit margins for healthcare providers.  These drivers are PQRS, Meaningful Use Stage 2 (MU2), ICD-10, and Health Insurance Exchanges (HIX). Any one…


How to Avoid Denials for Excisions and Repairs

In the recent AAPC article “Know When to Report Excision or Repair (or Both),” the coding rules for performing excisions and repairs for both malignant and benign lesions are described. The following decision tree provides guidance on when it is appropriate to report repairs separately (per AAPC): Is it a simple repair (e.g., involving “primarily…


Quick Facts About Health Insurance Exchanges (HIX)

America’s current status of HIX: The deadline for states to declare their intentions on whether they will build their own exchange or have the government do it has been extended to Dec 14. Some states are currently undecided, but policy leaders are warming up to HIX overall now that the election is over and there appears to…


Election Results: What Do They Mean for Healthcare?

Now that the election season has come to a close, what does that mean for us in healthcare? Will Legislation Change? HITECH Act – No change, unless budgets are overturned; includes Meaningful Use, HIPAA Security, and Health Information Exchanges (HIE). The funding for these programs is relatively secure with either party having a majority. Adopting…


Create Interoperability Now for Changes Ahead

As the use of various technology systems continues to increase within medical practices, interoperability between those systems becomes critical. An article called, “Interoperability a Key to Effective Communication” on the AAPC website states, “Disparate computer systems must communicate structured data in a way that both systems understand.” Consequences of having disparate systems could mean a…


Importance of E/M Outliers for Current Clients

In today’s coding environment, internal auditing is an important business process for avoiding costly repayments and other punitive measures for bad billing. Evaluation and Management (E/M) services are always highly monitored by auditors since those services represent such a large percentage of Medicare Part B billing. What to know Your internal auditors ought to be familiar with their…


Importance of E/M Outliers

In today’s coding environment, internal auditing is an important business process for avoiding costly repayments and other punitive measures for bad billing. Evaluation and Management (E/M) services are always highly monitored by auditors since those services represent such a large percentage of Medicare Part B billing. What to know Your internal auditors ought to be familiar…


CLDPP to Combat Increasing Payor Rules

AMA’s 2012 National Health Insurer Report Card provides interesting insight into what the revenue cycle might look like in the next few years (Learn more about the AMA 2012 Report Card, here). There are two interesting observations on the data that need to be considered with respect to what types of tools provider organizations will need in the future…


AMA’s 2012 National Health Insurer Report Card

The AMA has published its National Health Insurer Report Card, comparing data from seven commercial payors and Medicare on key administrative metrics. While there have been great improvements that have saved the healthcare industry billions of dollars, this report shows a few interesting findings that directly correspond with a physician’s bottom line. Click HERE to continue reading. 


Finalized ICD-10 Implementation Date and Stage 2 Meaningful Use Requirements

Today, CMS made final a one-year proposed delay (from Oct. 1, 2013, to Oct. 1, 2014) in the revised ICD-10 implementation date.  The CMS final rule report ends months of speculation about the timing of ICD-10. Practices and providers will need to make preparations well in advance of the conversion date to prevent revenue losses.

In addition, an extended timeline for early adopters of Meaningful Use has been adopted. The Stage 2 rule gives providers more time to meet Stage 2 criteria. A provider that attested to Stage 1 of meaningful use in 2011 would attest to Stage 2 in 2014, instead of in 2013. Therefore, providers are not required to meet Stage 2 meaningful use before 2014. For more information, please click here.  


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