Medical Billing Blog with Medical Billing & Coding Info & Articles
Our blog contains news and articles relating to numerous healthcare sectors including revenue cycle management, medical billing, medical coding, ICD, HIPAA, practice management functions and more.
Understanding HIPAA’s Medical Record Transfer Rules
“I recently received an inquiry from a physician who was frustrated by patients returning to his practice multiple times seeking copies of the same medical records. He described a situation where he (“Physician A”) had properly transferred a patient’s medical records to a new physician (“Physician B”). The patient then left Physician B to transfer to Physician C. Physician B was willing to transfer his own medical record for the patient to Physician C, but did not include the portion of the medical record provided by Physician A. Physician A was then required to provide his medical record to the patient again and wondered whether this was a common issue …
Tips for Succeeding at MIPS
With the CMS’ Merit-Based Incentive Payment System (MIPS) and value-based care model in full effect, it’s important for physicians to understand what MIPS means for their practices, particularly when it comes to understanding what types of technologies are available to help them avoid a negative adjustment to their Medicare reimbursement. As a practicing dermatologist, I’ve faced the ongoing challenges that evolving government mandates present and their subsequent reporting requirements. That said, these mandates, particularly MIPS, present an opportunity to refine and streamline existing regulations, while also taking a concerted step toward an effective quality care model and reimbursing physicians for value over volume. While another health IT mandate may seem …
Proposed QPP rule extends reprieve to small practices
The recently issued 2018 proposed rule for the Medicare Access and CHIP Reauthorization Act’s Quality Payment Program includes a threshold increase that would lessen Merit-based Incentive Payment reporting requirements for small and rural practices, according to Justin Barnes, board advisor at iHealth Innovations. Mr. Barnes shared the following tip with Becker’s Hospital Review. “The proposal extends transition year flexibilities into the 2018 reporting period and introduces bonus points for small practices, 2015 Certified Electronic Health Record Technology use and the care of complex patients. The rule also proposes postponing introduction of the MIPS Cost performance category… Continue reading this article
What it Takes for a Successful EHR Implementation
In a recent article in Harvard Business Review, the former CEO of the Permanente Medical Group Robert M. Pearl, MD relayed his experiences installing an Epic EHR system ten years ago and the factors responsible for a successful EHR implementation. Despite the hefty cost of implementation — in the area of $4 billion — the EHR system quickly proved beneficial in delivering more efficient, accurate patient care because of the right approach, according to the now Chairman of the Council of Accountable Physician Practices. However, not all physicians have such a positive experience. Many remain skeptical the advantages of EHR implementation outweigh the costs and administrative strain. Several Boston physicians …
RCM tip of the day: Start by starting
When seeking to improve revenue cycle management, healthcare organizations should develop a specific plan for each initiative, according to Jim Denny, president and CEO of Navicure. Mr. Denny shared the following tip with Becker’s Hospital Review. “Despite new and ongoing revenue cycle burdens, the real key to making improvements is to start by starting. I always remind our clients to develop a list of needed initiatives for the current year, as well as upcoming years, and approach one or only a few top priority initiatives at a time. For example, if your organization’s days in accounts receivable are through the roof, start by leveraging a data analytics tool to understand …
How to Collaborate for EHR Usability
The number of health IT developers and products has increased significantly as a result of federal incentives for EHR adoption but correlates with the rise of provider dissatisfaction with the usability of these systems. What providers expect from their EHR systems and what health IT developers deliver have proved not to be one in the same. This disconnect points to the need for the latter to focus on the needs of the former and deliver EHR technology that is user-centered. Therefore, collaboration between health IT developers and clinical end-users is key to ensuring EHR systems are user-friendly in an industry rapidly adopting new technologies year after year to tackle new …
Cybersecurity Taskforce Issues EHR Security Recommendations
A healthcare industry cybersecurity taskforce recently submitted a report to Congress analyzing and addressing various issues with healthcare security including problems unique to EHR technology. The task force was initially convened in March of 2016 by HHS and consisted of members representing organizations ranging from hospitals to pharmaceutical companies. Throughout the year, taskforce members shared information regarding cybersecurity best practices, trends, threats, and general concerns regarding health IT safety. The task force also posted blogs encouraging the public to submit feedback and present ideas the taskforce could draw from when addressing requirements of the Cybersecurity Act of 2015. Ultimately, the taskforce devised the following six imperatives to increase current levels …
Configuring a chargemaster for medical services
Configuring a chargemaster for medical services is like constructing a building. The more complex the building (or medical services), the more planning, skill, and manpower needed to do the job. The chargemaster of a primary hospital will be different from a tertiary hospital with more acute specialty services. The volume of services rendered gives an estimate of the volume of chargemaster transactions, while the variety and complexity of services rendered gives an idea of the resources needed. Dedicated training, level of expertise, attention to details, and the skill of the chargemaster team determine a successful outcome. The Basics 1. Know your payers and its policies (i.e. what Medicare Jurisdiction the …
Incident-to Coding: Physician vs. Non-physician Provider
Question: Our practice needs to make sure that “incident-to” guidelines are being followed? Part of the Medicare guidelines is that the physician must stay involved in the patient’s care, but they don’t give a specific timeframe. If the patient only sees the non-physician provider (NPP) once or twice a year, and only sees the physician every two to three years, would Medicare consider that as the provider staying involved in the patient’s care? Answer: Once upon a time… Continue reading this article
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 …
