The shift to value-based care has driven public and private payers to redesign reimbursement models that stress accountability for care quality and healthcare costs. As the fee-for-service environment fades away, alternative payment models like bundled payments are helping to define the future of revenue cycle management.

On a recent onsite, one of the clinical documentation integrity specialists (CDISs) asked me my opinion on how assiduous a clinical documentation integrity (CDI) professional should be to get a query answered. My response may surprise some of you.

Technology is enabling patients and providers to connect in an unprecedented manner. The Internet, smartphones, wearables, and other technologies are allowing for instantaneous communication...

The ambiguities of Medicare regulations often create conundrums for case managers and physician advisors as we try to advocate for our patients while remaining compliant.

Many procedural codes in the CPT^® Book are designated as “separate procedures.” However, the common misinterpretation of this is that coders can report such codes as such in every case.

Long-term care professionals have been diligently cramming to prepare for a new skilled nursing reimbursement system in October, but a data expert had a sobering observation for presentation attendees Friday.