Medical Billing Blog with Medical Billing & Coding Info & Articles

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Welcome to the medical billing blog containing news and articles relating to medical billing, medical coding ICD-10, HIPAA and all practice management functions.

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Currently contains over 1,170 healthcare and medical related entries.

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7 strategies to prevent claims denials

Claims denials pose a serious issue for hospitals amid an already complicated reimbursement landscape. “Denials are a huge obstacle to timely and complete reimbursement,” said Carmen Sessoms, associate vice president of the revenue cycle management advisory services program at Nashville, Tenn.-based Change Healthcare. In 2016, Change Healthcare managed 1.8 billion transactions with a value of more than $3 trillion. Leveraging this data, analysts determined approximately 9 percent of claims with a value of $262 billion were denied. These denials impacted about 3.3 percent of net patient revenue, translating to an average of $4.9 million per hospital. Denials are not only highly prevalent in the healthcare environment, but also very costly

By: Melissa Clark, CCS-P, RT - CEO
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Hypertension Coding in the Age of Quality

The hypertension “epidemic” hearkens back to boxer Joe Louis’ words regarding a smaller, quicker opponent — light heavyweight Billy Conn, “You can run, but you can’t hide!” No matter what specialty of medicine or surgery you practice, or whether you are a primary-care provider, elevated blood pressure represents a recurring problem that will not go away. Furthermore, hypertension is often accompanied by comorbid conditions such as diabetes mellitus, obesity, CKD-3, and systolic dysfunction which complicates blood pressure treatment, according to researchers at University of Miami Miller School of Medicine. The downside of this epidemic is clear, untreated blood pressure is fraught with multiple target organ complications. In fact, approximately 80

By: Melissa Clark, CCS-P, RT - CEO
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Most Providers Report Lack of Health IT Interoperability

A new eHealth Initiative survey found 68 percent of providers believe current interoperability solutions fail to help meet the goals of value-based care. Researchers in 2017 Survey on Access to Patient Information gathered responses from 107 respondents including CEOs and other executive leadership, IT leadership, clinical staff, and administrative leadership from hospitals, health systems, medical groups, physician practices, HIEs, and other organizations. The survey addressed issues including health data exchange, interoperability, federal regulations, patient access to information, and patient engagement. Researchers found that most providers believe technology has improved healthcare quality since 2008, but certain areas—including interoperability—are still in need of significant improvements. “Sixty-three percent agree that technology has helped

By: Melissa Clark, CCS-P, RT - CEO
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Healthcare security compliance in the cloud

The “cloud” has almost become a buzzword in health IT, with many hospitals considering a shift to remote servers to reduce costs and improve scalability. However, some executives have hesitated, given the cyber-security implications of accessing protected health information through the internet. “It’s like online shopping,” Shaung Liu, chief technology officer of the provider division at Teladoc, said during a Microsoft-sponsored workshop at the Becker’s Hospital Review 3rd Annual Health IT + Revenue Cycle Conference Sept. 21 in Chicago. “When you first did online shopping nobody wanted to put their credit card in the cloud … you didn’t trust it,” he explained. “Now, everybody does.” Teladoc, a telehealth company that

By: Melissa Clark, CCS-P, RT - CEO
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10 Common Physician RCM Mistakes

If you’re familiar with the beloved sitcom “Seinfeld,” then you have probably seen “The Opposite,” an episode where George Costanza takes it upon himself to do the complete opposite of what he believes is right. The episode serves as the inspiration for Craig Pedersons’ presentation, “Physician Compensation: 10 Common Mistakes (and Four Solutions),” at the Medical Group Management Association (MGMA) Annual Conference in Anaheim, Calif. “I am going to go through case studies and specific examples of financial train wrecks. I’m not trying to tell people what to do, I’m telling them what to avoid. Case studies allow examples to become a lot more real,” says Pederson, a principle consultant

By: Kathryn Etienne, CCS-P, RT - DOO
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The Cloud Protects Practices from Mother Nature

Late last week, as Irma devastated Florida’s Atlantic and Gulf coasts, I had the opportunity to speak with one of our medical practices in the area. As I shared my concerns and best wishes with them, they quickly reminded me how valuable it is to have their entire practice’s data securely stored in the cloud—far away from the rain, devastating winds, and storm surge. With the destruction left in the wake of hurricanes Irma and Harvey, it is wonderful to know that cloud technology is helping people worry less and avoid further damage. Here are four disasters modern medical practices across the southern U.S. will sidestep in the storm aftermath:

By: Melissa Clark, CCS-P, RT - CEO
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Is Your EMR User Friendly?

A common complaint about EMRs is that while they might have technical capability, they might not have real world usability, or be “user friendly”. Thus, you might be able to enter A, B and C; but finding the previous values of A, B and C might be challenging, and seeing the history of A, B and C might not be possible. As I sat in front of one of my medical providers recently, who is a late and reluctant convert to EMRs, he created an on paper list of my previous values as he inefficiently hunted through my now online history. And unless he types them back in in a

By: Melissa Clark, CCS-P, RT - CEO
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EHR companies refuted claims of violating HIPAA

The EHR Association (EHRA) Executive Committee has fired back at accusations that EHR companies are partially to blame for interoperability problems, claiming health data exchange is progressing quickly. The association published a response to an earlier post on Health Affairs Blog that accused EHR and health IT companies of monetizing the custody of patient protected health information (PHI). Former ONC Chief Privacy Officer Lucia Savage urged the Office of Inspector General (OIG) to enforce provisions of HIPAA prohibiting business associates such as EHR developers from using PHI for business operations. She stated some EHR companies may be leveraging ownership of patient PHI for profit. “Building a revenue stream out of

By: Melissa Clark, CCS-P, RT - CEO
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