Value-based payment reform will be the key to lowering healthcare costs and improving care quality, according to health economist Michael Chernew, PhD. At AHIP’s 2019 Institute & Expo in Nashville last week, the Leonard D. Schaeffer Professor of Health Care Policy explained that, of all the reforms...

When we started our medical billing enterprise in 1994 I had no prior experience at billing any medical claims, not to mention secondary and tertiary. I knew nothing. In fourteen years of billing I’ve discovered much and I see from questions in our discussion board that many newbies don’t perceive secondary and tertiary claims billing in any respect.

It's no secret that today's generation of consumers is much different than 20 years ago (and even 10 years ago). Regardless of what we’re buying or who we’re engaging with, we want communication to be as quick and easy as possible—and preferably from our mobile devices.

I frequently encounter complaints by healthcare providers that when they are undergoing Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), and, more recently, the Targeted Probe-and-Educate (TPE) audits, the auditors are getting it wrong. That’s as in, during a RAC audit, the auditor finds claims noncompliant, for example...

CMS posted changes to the ICD-10-CM codes for fiscal year 2020.

Five key points: 1. There were 71,932 ICD-10-CM codes for fiscal year 2019. The update includes 72,184 codes. 2. CMS added 273 codes, deleted 21 codes and made 30 revisions to codes pertaining to various treatments...