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Exceptional Coders | Innovative Technology

Coding Contest Finding 41% Outpatient Coder Accuracy Demonstrates the Need for Improvement

Posted by David Fong on Dec 12, 2017 6:00:00 AM

A recent nationwide ICD-10 coding accuracy and productivity contest by Central Learning demonstrates the fact that the medical coding industry still needs to greatly improve in order to achieve a respectable and acceptable ICD-10 and CPT coding accuracy level. Although there was a slight improvement in inpatient and emergency department accuracy, the ambulatory surgery accuracy score decreased. The average inpatient coder accuracy was 61 percent and the average outpatient coder accuracy was 41 percent.

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Topics: Medical Coding, HIM, Medical Coding Audits

Average Hospital Leaves $22 Million on the Table Due to Poor Revenue Cycle Performance

Posted by David Fong on Nov 28, 2017 6:30:00 AM

The Advisory Board Company in a press release earlier this year announced that the average 350-bed hospital has an overlooked opportunity of up to $22 million in revenue capture. Improving revenue cycle performance to decrease missed revenue opportunity means responding to four market forces.

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Topics: Medical Coding, HIM, Denial Management

Outsourced Coding and Health Information Management Market Expected to Double in 2018 – Aviacode Once Again Ranked Among the Top Outsourced Coding Vendors

Posted by David Fong on Nov 13, 2017 12:00:00 PM

A recent Black Book Market Research survey indicated that the outsourced coding and Health Information Management market is expected to double in 2018. Within this survey, Aviacode was once again ranked among the top vendors in outsourced coding.


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Topics: Medical Coding, HIM

Can Your Specialty Use Help with the New 2018 ICD-10 Coding Changes?

Posted by David Fong on Oct 31, 2017 11:15:00 AM

This year's new ICD-10 coding changes affect many different medical specialties. Here a just a few of the changes for some medical specialties as listed from CMS.gov.

 

Be sure to check the complete files to see the details on the changes that will affect your specialty. To view the changes, download the Addendum from the CMS 2018 ICD-10-PCS and GEMs page. Go to https://www.cms.gov/Medicare/Coding/ICD10/2018-ICD-10-PCS-and-GEMs.html

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Topics: Medical Coding

Final ICD-10-CM Codes for 2018 Are Varied and Complex – Are You Ready?

Posted by David Fong on Oct 17, 2017 7:00:00 AM

October 1, 2017 introduced the mandated code updates for thousands of FY 2018 ICD-10-CM and ICD-10-PCS codes. Necessary code changes must be incorporated into every hospital, physician practice, medical provider, payer billing, and abstracting system, and/or encoder.

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Topics: Medical Coding

DOJ Takes Action on Medicare Advantage Overpayments

Posted by David Fong on Sep 28, 2017 6:00:00 AM

As you are well aware, Congress created Medicare Advantage (MA) as a risk adjustment payment program that pays insurers more for sicker beneficiaries. Payers in MA receive a yearly fee for each enrolled member and monthly risk adjustment payments for each enrolled beneficiary, based partly on the person’s health status. This program can be open to fraud. Medicare Advantage payers received about $160 billion in 2015 for approximately 16 million beneficiaries. HHS estimates that the FY 2015 Medicare Part C gross improper payment estimate is 9.50 percent or $14.12 billion, along with the FY 2015 net improper payment estimate of 4.32 percent or $6.41 billion.


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Topics: Medical Coding, HCC Coding, Coding Compliance, Medical Coding Audits

Aviacode Joins AHIMA’s Outpatient/Physician Coding Month Celebration

Posted by David Fong on Sep 14, 2017 9:45:00 AM

Aviacode joins AHIMA in celebrating and showing our appreciation for all the outpatient coding professionals during the month of September.

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Topics: Revenue Cycle Management, Medical Coding

Better Coding and Record Keeping Can Improve Care and Reimbursements for High-Risk Patients

Posted by David Fong on Aug 29, 2017 7:00:00 AM

An article in Modern Healthcare magazine reported that physicians who serve low-income patients with complex conditions are more vulnerable to financial losses in value-based payment models. The study that found these providers, many of them safety-net providers, didn't have the technological infrastructure to report the necessary data.


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Topics: Medical Coding, HCC Coding, Coding Compliance, Medical Coding Audits

Five Ways to Reduce Healthcare Administrative Costs Includes Outsourcing

Posted by David Fong on Aug 14, 2017 5:00:00 AM

A recent Managed Healthcare Executive magazine article entitled: “Five ways to reduce healthcare administrative costs,” identifies five strategies that healthcare executives can use to reduce onerous administrative costs. According to the article, administrative costs make up about 15 percent of all healthcare expenditures -- well over $300 billion annually, as found in the 2016 index report from the California Association for Healthcare Quality. Outdated, manual processes and rejected claims eat up a large portion of this administrative cost.


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Topics: Revenue Cycle Management, Medical Coding, outsource

HCC Coding Needs Rise as Medicare Advantage Gains Increased Popularity

Posted by David Fong on Jul 21, 2017 7:00:00 AM

Medicare Advantage (MA) is a complex program that continues to gain popularity, with about one-third of Medicare beneficiaries currently enrolled in a variety of MA programs. MA plans are issued by MAOs, or Medicare Advantage Organizations, that are typically insurance companies.

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Topics: Revenue Cycle Management, Medical Coding, HCC Coding