Medical Billing Blog with Medical Billing & Coding Info & Articles

Welcome to the Medical Billing and Coding Blog

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

Click any of the article links below or browse by section to the right to read articles on a specific subject.

View provider enrollment as a critical part of your RCM

Provider enrollment with payers is crucial, as it ensures proper reimbursement for services rendered, according to Patrick Doyle, senior vice president of Newport Credentialing Solutions. Mr. Doyle shared the following tip with Becker’s Hospital Review: “To ensure every collectible dollar is received, provider enrollment must become an integral part of the revenue cycle process. Best practices should include regular payer audits to validate provider participation status, rigorous payer application follow up, monitoring of licenses and expiring documents, Council for Affordable Quality Healthcare re-attestations and re-enrollments. Furthermore, understand your at-risk revenue against your open enrollments. These are charges billed by providers when their enrollment status is in-process. In-process enrollments for payers

By: Melissa Clark, CCS-P, RT - CEO
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2018 ICD-10-PCS Code Changes

The U.S. Department of Health & Human Services (HHS) has released the code changes for ICD-10-PCS coding system. ICD-10-PCS codes were adopted under HIPAA for hospital inpatient healthcare settings to use for reporting procedures. Their guidelines help healthcare providers and coders to accurately identify procedures to be reported on healthcare claims. The 2018 updates will reflect services from Oct. 1, 2017 through Sept. 30, 2018, so be sure to update your medical records to account for the changes. There were 75,789 codes in 2017. In 2018, the number jumps to 78,705…   Continue reading this article  

By: Melissa Clark, CCS-P, RT - CEO
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EHR Data Helps Scientists Detect Heart Failure Earlier

Joint research between IBM Research and Sutter Health led to the development of methods for predicting heart failure using clues imbedded in patient records in Epic EHR technology. Researchers observed the performance of machine learning models designed to detect prediagnostic heart failure in primary care patients using longitudinal data in EpicCare EHRs. “Information that can be gained on populations of patients from longitudinal EHR data can be used to individualize care for a given patient,” Ng et al. stated. “Access to these data in combination with the rapid evolution of modern machine learning and data mining techniques offers a potentially promising means to accelerate discoveries that can be readily translated

By: Melissa Clark, CCS-P, RT - CEO
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EHR is Still a Top Buying Priority for Physicians

A recent survey of healthcare executives shows that inpatient and outpatient EHR technology are top of mind for provider buying priorities for health IT purchases, trailing only telemedicine. A third of 248 respondents to a Research Data survey listed telemedicine (33%), inpatient EHR (32%), and outpatient EHR (32%) solutions as their current top health IT buying priorities. The three technologies were well ahead of MACRA implementation and patient engagement, both reported by 20 percent of healthcare executives, as health IT purchasing priorities. The greatest number of respondents — ranging from healthcare CEOs, CIOs, and CFOs to IT, medical, and nursing directors — working in standalone hospitals (47%) and integrated delivery

By: Melissa Clark, CCS-P, RT - CEO
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4 Initiatives Advancing Healthcare Interoperability in 2017

Healthcare interoperability has been a priority for vendors and providers since the advent of health data exchange. Timely access to accurate health information regardless of health IT system or location improves provider communication and patient care delivery across the care continuum. This year, healthcare organizations, health IT developers, and federal agencies alike have made a concerted effort to push the industry closer to its goal of true interoperability. The following are four recent initiatives and forthcoming projects aimed at transforming interoperability in healthcare in 2017…   Continue reading this article  

By: Melissa Clark, CCS-P, RT - CEO
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RCM tip: MACRA calls for a cross-departmental effort

Healthcare organizations should seek cross-departmental collaboration in preparing to manage and execute Medicare Access and CHIP Reauthorization Act initiatives, according to Joncé Smith, vice president of revenue cycle management at Stoltenberg Consulting. Ms. Smith shared the following tip with Becker’s Hospital Review. “Although many may see the IT department as the owner of an initiative like MACRA, true progress can only be achieved from a cross-departmental collaboration among financial, clinical and IT departments. Financial leaders serving on this committee should be responsible for managing the organization’s reporting path, including working with clinical leaders to select the appropriate program measures under either the APM or MIPS track. After all, these program

By: Melissa Clark, CCS-P, RT - CEO
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Are Biometrics the Future of HIPAA Security?

Medical electronic health records, or EHRs for short, may have the potential to be much more secure than conventional records. That sounds like a bold claim in light of news about data breaches involving personal information. In fact, according to a report from the Identity Theft Resource Center and CyberScout, the number of tracked data breaches in the United States in 2016 hit an all-time high of 1,093. And still, more than 78% of doctors use EHRs, says the CDC. For medical professionals and the healthcare industry as a whole, keeping sensitive data secure and adhering to HIPAA regulations is a top priority. After all, EHRs can include years of

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