ICD-10 Specificity Has Providers Bracing for Denials
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A year after the much-hyped switch to the ICD-10 diagnostic coding library, healthcare providers now face pressures to assign codes with the right degree of specificity or risk claim denials.
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Medical billing for dental offices and the 2017 CDT updates: What you need to know
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Do you bill medical insurance for medically necessary dental procedures performed in your office? If you do, it’s important to understand the changes to the CDT codes for 2017.
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Aggressive Tactics by Third Party Auditors Should Make Providers Vigilant
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The goal was to avert fraud, waste, and abuse. We all support that – we collectively pay for Medicare, and who likes throwing their money away? Let’s review the ideal: the patient receives excellent medical care, the provider does...
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Is Cyber-Security Insurance Right for Your Practice?
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2015 was a notorious year for cyber attacks in the healthcare industry, with more than 100 million health care records compromised in a single year. So far 2016 looks like it might be as bad or worse, once the Department of Health and Human Services' (HHS) Office of Civil Rights (OCR) gets all the breaches
posted.
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Downgrading DRGs: A New York Epidemic Out of Control
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Do you find that your facility’s DRGs are being downgraded by third-party payers that are re-diagnosing patients? Are they also discounting the coding of suspected and possible diagnoses? You’re probably not alone. Sonya Manuel, a senior health information management (HIM) consultant and DRG coordinator for Jzanus Consulting in New York, tells RACmonitor that the battle with
third-party auditors has been going on for years.
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