Becker's Hospital Review reported on the following payment model updates from CMS or HHS in October...

Too little attention is paid to documentation, coding, and billing in many medical practices. For patients, documentation simply means that your doctor is providing an account of your visit in your medical record. However, documentation and coding can affect revenue, quality of care, and possibly expose clinicians to legal consequences.

Providers should keep in mind that such policies aren’t binding – but can offer valuable direction. Imagine your Medicare Administrative Contractor (MAC) had a policy detailing their coverage of records documented by a scribe.

Securing successful contracts with payers is becoming increasingly important for ASCs as they move toward negotiating value-based contracts.

Lisa Davis, administrator at The Center for Minimally Invasive Spine in Munster, Ind.; Scott Allen, vice president of managed care contracting at National Medical Billing Services; Heather ...

In light of new value-based care models and creative partnerships between providers, CMS is ditching its pay-and-chase approach to reducing Medicare fraud, waste, and abuse and implementing a new five-pillar approach based on prevention and technology. In a new CMS blogpost, the agency’s administrator Seema Verma detailed the new approach to reducing Medicare fraud, waste, and abuse, which includes:

In an effort to help broaden the ways in which social determinants of health can inform clinical decision making, eHealth Initiative & Foundation has recently released some new tools to promote the use of ICD-10-CM codes to capture SDOH data in the electronic health record.

Most healthcare organizations partner with physician services groups for niche coverage. While outsourced medical services are available across all specialties, common areas for external physician support include anesthesia, radiology, wound care, and emergency medicine. However, when outsourced physician services are used, challenges..