This article outlines risks and articulates a risk management framework that will guide both payers and providers through the ICD-10 transition.
The process of implementing ICD-10 yields vital strategic assets not directly related to ICD-10.
Implementing an EHR system is only the first step in reaping its benefits. Providers can take simple steps, without vendor involvement, to take better advantage of their system.
Denials Management By Shawn Tienken
Developing a sound denials management program requires that an organization implement a global approach in order to minimize cost and maximize revenues.
Healthcare organizations recognize the need for enhanced understanding of their businesses in order to be successful in the fast-changing landscape of healthcare. In order to accomplish this, these organizations must embrace a holistic approach to business intelligence that goes beyond data infrastructure and tools used for advanced analytics.
The United States has the highest healthcare spending in the world while scoring among the lowest on key health indicators. The goal of ACOs is to shift the focus of healthcare from volume to value, as participating organizations agree to be financially accountable for the quality and cost of care.
Is your organization prepared to meet the 2014 Meaningful Use requirements? Effective January 2014, regardless of stage, eligible Hospitals and Providers may be able to report for meaningful use demonstration. Meaningful Use, a set of standards established by the CMS Electronic Health Records (EHR) Incentive Program, promotes the effective use of the EHRs that optimally enhances patient care. Meaningful Use demonstration is phased into 3 stages, with only Stages 1 and 2 active. On December 6, 2013,
On November 27, 2013, the Obama Administration made a critical decision to delay the launch of Small Business Health Care Options (SHOP) Marketplace through the HealthCare.gov website until November 2014. This one year delay comes in light of the challenges in launching the individual health exchange. However, small businesses still have the option of enrolling employees into certified SHOP health plans through agents, brokers, or insurers. Qualified small businesses can work directly with their agents, brokers, or insurers to submit...
All physicians who bill to Medicare will incur an automatic 1.5% penalty on all Medicare reimbursements in 2015 if they do not sign up to submit clinical quality measures (CQM) through the Physician Quality Reporting System (PQRS) by October 15, 2013. The penalty increases to 2.0% in subsequent years. Further, in 2015, CMS will begin applying a “value-based modifier” (VBM) to the clinical quality measures (CQMs) for physician groups of 100+, which will result in an automatic 1.0% penalty on all...