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Medical Groups and Hospitals Support CMS Proposal to Abandon E/M Coding Changes

Posted by David Fong on Sep 30, 2019 7:00:00 PM

Major medical groups and hospitals have backed the CMS' decision to abandon a provision of the finalized 2019 Medicare Physician Fee Schedule rule that would have consolidated the number of Evaluation and Management (E/M) payment levels into one payment rate beginning in 2021. The agency initially proposed the E/M coding measure in the belief that it would reduce clinicians' work to get Medicare reimbursement. However, providers worried that lower reimbursement rates would cut into their bottom lines and create a number of unintended consequences that could hurt patients.

 

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Topics: Revenue Cycle Management, Medical Coding

Big Changes for Long-Term Care Coding and Billing with New PDPM Rules

Posted by David Fong on Sep 12, 2019 11:00:00 AM

Managers of skilled nursing facilities are eagerly anticipating changes that will change the way they code, bill, collect data, and operate. A September 2019 article from McKnight’s Long-Term Care News details the long-awaited changes for long-term care reimbursements through the new Patient-Driven Payment Model (PDPM). The changes, which go into effect October 1, are revisions to the Resident Assessment Instrument (RAI), which is essentially the “rulebook” for Medicare and Medicaid reimbursements.

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Topics: Revenue Cycle Management, Medical Coding

Mid-Revenue Cycle Management Market Heating Up

Posted by David Fong on Feb 28, 2019 3:35:45 PM

Mid-revenue cycle management is concerned with the phase of the process between the point where a patient accesses care and the care provider’s business office. Typically processes during this time include documentation, coding, CDI, and compliance. A recent Markets and Markets report  expected sustained growth in this market. It projects a compound annual growth rate (CAGR) of 7.9 percent and a market size of $4.5 billion by 2023.

 

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Topics: Revenue Cycle Management, Medical Coding, Clinical Documentation, CDI

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

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

Aviacode Joins AHIMA’s CDI Month Celebration

Posted by David Fong on Jul 5, 2017 10:30:00 AM

Not only is clinical documentation improvement (CDI) the key to better ICD-10 coding and reimbursement accuracy, but it's also vital for preparing healthcare organizations for the new care paradigm of population health management. To this end, AHIMA has designated the month of July as CDI Month with Aviacode joining in the recognition to CDI professionals nationwide.

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Topics: Revenue Cycle Management, Medical Coding, Clinical Documentation

Coding and Patient Financial Services – Working Together to Create a Healthy Revenue Stream

Posted by David Fong on Jun 21, 2017 5:00:00 AM

There are two key players in revenue cycle stream – the HIM coding department and the patient financial services department. Working together these two departments can sustain a healthy revenue cycle for any healthcare organization. These two departments are responsible for all of the basic elements of the revenue cycle -- from registration to coding the care provided to final discharge.

 

 

Patient financial services, typically, includes the registration process, and that is where the revenue stream has its head waters. An accurate registration process establishes the basis for future follow-up with payers or the patient as a self-payer.

 

Using their knowledge of billing rules, patient financial services applies the appropriate billing rules, such as Local Medical Review Policies (LMRPs) or National Coverage Determinations (NCDs) to produce an accurate patient bill.

 

The HIM coding department uses its vast knowledge of the very latest coding rules to provide patient financial services with an accurate medical record from which to produce their patient bill.

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Topics: Revenue Cycle Management, Medical Coding, Denial Management

4 Common Trends in Healthcare Finance for 2016

Posted by Ben Castleberry on Jun 24, 2016 12:00:00 PM

 

The world of healthcare is currently undergoing many changes. One of them being the switch to value based care.   Below are some trends successful organizations have implemented to keep up with it all.

 

  • Mergers

Merging healthcare organizations has become and will continue to be a popular choice for many organizations. The healthcare world is all about acquiring patients. One of the best methods to increase a hospitals patient base is to be involved in a merger. Bigger hospitals are more likely to be successful by providing patients with more affordable services. Small organizations will likely stay in a fragile state.

 

  • Technology Advancements

Technology is always advancing. Even though most organizations have implemented different types of technology into their systems, there will always be improving systems that arise. Below are some new technology trends that will be affecting the healthcare world in 2016.

 

Health Monitoring Devices

It has become quite a popular trend for the public to monitor aspects of personal health by wearing Fit Bits or other similar devices. This can greatly impact and improve patient care. Hopefully people using these devices will be able to pay more attention to their health, and the limitations their body has. When patients are familiar with their vitals, exercising habits, and sleep patterns it may help doctors come up with more accurate diagnoses.

 

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Topics: Revenue Cycle Management, Medical Coding

The After Effects of the Transition to ICD-10

Posted by Ben Castleberry on Jun 21, 2016 1:00:00 PM

 

The United States was one of the last countries that transitioned into the ICD-10 code set, which carries a high volume of codes allowing provider’s to be much more detailed in their medical records when compared to ICD-9.

 

With this new pool of codes, many healthcare experts predicted the transition to ICD-10 would cause quite a bit of disruption for the industry’s profitability. Surprisingly enough, these expectations have not panned out. In fact, those studying the effects of ICD 10 have found minimal effects.

 

The average productivity decline for the year is 14%, which is much lower than to be expected. Some of this decline in productivity may not even be contributed to the switch to ICD-10. Researchers noted that a new computer-assisted coding technology was introduced around the same time, which could account for some of the decline in productivity.

 

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Topics: Revenue Cycle Management, Medical Coding