Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Policy & Regulation News

CMS Reports $2.4B in Healthcare Consumer ACA Premium Rebates

by

Consumers are apparently receiving major bang for their buck, although not in relation to this week’s hard-to-miss Black Friday and Cyber Monday holiday sales brouhaha. Healthcare consumers have received over $2.4 billion premium rebates...

CMS Approves Outpatient Ambulatory Patient Experience Survey

by

How can you best measure patient experience? Perhaps with a 37-question survey. The Centers for Medicare & Medicaid Services (CMS) has approved the administration of an Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare...

Why ICD-10 Denial is an Easy Electronic Health Record Fix

by

Did Electronic Health Records (EHRs) save the healthcare industry from massive post-ICD-10 implementation claims denial? The healthcare industry will not have a confident grasp about tangible payment process success until Thanksgiving, said Joshua...

CMS Announces Top 3 Volume to Value Medicare Payment Goals

by

Patrick Conway, MD, MSc, Chief Medical Officer at the Centers for Medicare & Medicaid Services (CMS), is speaking out about the administration’s overarching goals for Medicare’s future. In yesterday’s blog post,...

Nov. 20: Week That Was in Healthcare Fraud and Malpractice

by

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported below result in multiple millions of dollars...

Senate Committee Approves Rural Health Care Connectivity Act

by

Those living in rural areas of the country without a hospital delivering affordable care nearby may soon be at ease due to passage of a new bipartisan bill. United States Senator John Thune (R-SD), Chairman of the Senate Committee on Commerce,...

Is Data Collection too Burdensome in CMS Final Payment Rule?

by

A new 311 page final rule from the Centers for Medicare & Medicare Services (CMS) aims to amend the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system. CMS’s...

Why are Incorrect Characters a Top ICD-10 Coding Challenge?

by

Lack of training for inpatient procedural coding may pose a significant challenge for the healthcare industry as 2015 comes to a close, said Teri Jorwic, ICD-10 Educator and Professor of Healthcare Informatics at the University of Illinois at...

ICD-10 Mid-November Advice: Focus on Coding, EMRs, and KPIs

by

The healthcare world did not necessarily end with the ICD-10 switchover. Over 4.6 million daily claims throughout the month of October were reportedly processed with a 10 percent denial rate; 13 million claims were said to...

Public Health Funding for Disease Prevention Drops by $40B

by

Per capita health spending has dropped by over $40 billion from 2009 to 2014, confirm researchers David U. Himmelstein, MD, Lecturer at Harvard Medical School and Professor at the City University of New York (CUNY), and Steffie Woolhandler, MD,...

Why ICD-10 Coding Demands a Focused Compliance Perspective

by

Now that mid-November is here, healthcare entities should be prepared to respond to aggressive audits and clinical documentation enforcement efforts regarding ICD-10 code selections, or will face fraudulent billing claims. Such stated George...

November 13: Week That Was in Healthcare Fraud and Malpractice

by

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported below result in multiple millions of dollars...

How the Nursing Work Environment Affects Patient Outcomes

by

Nurses play a significant role in advancing favorable patient and nurse outcomes, says a recent report and accompanying press release from Press Ganey. “As a key player on the front lines of health care delivery, nurses play a critical...

How Successful is the ACA Really at Cutting Uninsured Rates?

by

Misunderstandings swirl as the Affordable Care Act’s (ACA) ever evolving ability to reduce the number of uninsured adults is continuously called into question. The total number of adults who have acquired health insurance coverage following...

GAO to CMS: State Medicaid Payment Flaws Hurt Transparency

by

The reliability regarding tens of billions of dollars in states’ supplemental payments is being called into question this month by the United States Government Accountability Office (GAO). Because complete reliable data is deficient, transparency...

GAO Reports Inadequate CMS Federal Exchange Coverage Control

by

Insufficient and inadequate policies and procedures from the Centers for Medicare & Medicaid Services (CMS) require greater levels of federal control to maintain effectiveness, says a report from the United States Government Accountability...

How a Cadillac Tax Repeal Affects Revenue Cycle Management

by

Repeal of the Cadillac Tax – a tax on high-cost healthcare insurance plans some private companies offer to employees – is up for debate once more, especially among recent presidential debate conversation and household...

Healthcare Consumers Demand More Coverage Comparison Options

by

A new pilot initiative involving a “Doctor Lookup” feature is now available for some healthcare consumers’ online perusal. Such a beta feature lets healthcare consumers compare coverage options in association with their individual...

November 6: Week That Was in Healthcare Fraud and Malpractice

by

Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported below result in multiple millions of dollars...

Medicare Home Health Agencies Face Upcoming Payment Changes

by

The Medicare home health prospective payment system (HH PPS) can expect payment changes next year, confirms an announcement from the Centers for Medicare & Medicaid Services (CMS). These payment changes aim to ensure greater payment...

Continue to site...