Risk Adjustment: Excitement and Anxiety
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The excitement and anxiety about risk adjustment in the healthcare industry is growing on a daily basis, and we are hearing tremendous hopes to learn and gain new expertise about the shift from fee-for-service (or volume-based) to fee-for-value (or value-based) reimbursement. Everyone in today’s healthcare organizations is feeling an increased
urgency... Click Here to Read More
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Importance of DRG Reconciliation in the CDI and Coding Processes
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The Centers for Medicare & Medicaid Services (CMS) performs diagnosis-related group (DRG) validation to ensure that reported diagnostic, procedural, and discharge status information matches both the attending’s description and the information contained within the beneficiary’s health record. CMS auditors are instructed to... Click Here to Read More
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MIPS Reporting: MACRA Final Rule Lists Available Quality Measures for MIPS reporting
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MIPS Eligible Clinicians can opt to report as individuals or as a group. A group is defined by the Tax Identification Number (TIN). If you choose this option, the group will be assessed as a group practice across all four MIPS performance categories. Eligible clinicians can take their reporting scores with them if they should leave the group during the reporting
period. Click Here to Read More
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Reimbursement, Billing in Radiology: Updates and Issues
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Radiology, as a business, has become increasingly complex as regulatory demands grow and revenues, both on the hospital and physician side decrease. Doing more with less has become a common theme and both the commoditization of billing as well as the implementation of ICD-10 codes have played an important role over the past year, according to industry experts at RSNA
2016.
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The Evolution of the International Classification of Disease
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The International Classification of Disease is perhaps one of the most important diagnostics documents in the medical world. It categorizes diseases and medical incidents that can be encountered, and the document reflects a broader context in which it is created. The ICD aids with health policy decision making and can
with a process of finding treatment for those who are suffering....
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