Healthcare Finance Staff

Along with Washington D.C., 23 states are expanding Medicaid eligibility under the Affordable Care Act, while 21 are currently on the record declining expansion and six are kind of on the fence.

The North Carolina Department of Health and Human Services' website will soon be publishing the prices of the 140 most common in-patient, surgical and imaging services performed by every hospital in the state.

As far as semantics go, therapeutics sound more appealing than generics, but researchers from the University of California, Los Angeles are saying that the switch may be worth it in more ways than just wordage.

Fraud in Kansas' Medicaid program increased 43 percent during the last fiscal year, reaching $33 million detected, some of it from a scheme that funded an 11-acre mansion.

As healthcare costs for employers continue to rise, they are taking steps to control costs and manage risks, finds two recent research reports.

Some accountable care organizations started long before the term was coined, with providers and payers forming risk-sharing agreements to improve outcomes and reduce costs.

You could put off communicating with your healthcare payers until you submit your first ICD-10 coded claim Oct. 1, 2014. What could go wrong? All kidding aside, early communication will help you test the ICD-10 claims process and gain insight into how reimbursements will be affected after Oct. 1, 2014. That second part will help prepare for DRG shifts. And it puts a price tag on procrastination. Early communication also will help you develop relationships with healthcare payers. This could help speed responses when you need answers and clarification during the claims process. The first step is to survey healthcare payers to understand ICD-10 readiness by asking: Are you prepared to meet the ICD-10 deadline of Oct. 1, 2014? Where is your organization in the transition process? Will you conduct external testing? What will we need to test with you? When will you be ready to accept test transactions from my practice? Will you be dual processing, and if so, when will you start? What will happen if something goes wrong? Who will be my primary contact at your organization for the ICD-10 transition? Can we set up regular check-in meetings to keep our progress on track? Do you anticipate any changes in policies or delays in payments to result from the switch to ICD-10? In return, providers need to: Communicate the status of the organization's ICD-10 transition. Share the information with the ICD-10 implementation team. Establish regular check-ins -- emails, phone calls or meetings -- with key payers. This part of the ICD-10 transition will take time and effort but there will be reward -- less financial disruption and stress. - See more at: http://www.physbiztech.com/best-practices/compliance/how-work-payers-icd-10#sthash.kQdyYalO.dpuf You could put off communicating with your healthcare payers until you submit your first ICD-10 coded claim Oct. 1, 2014. What could go wrong?

Playing off the title of Billy Joel's iconic 1976 song, the officials running New York's health insurance exchange announced Tuesday that they have chosen New York State of Health as the brand name of their new online marketplace. 

About one month before public insurance exchanges open, less than one-third of the healthiest, lowest-cost population acutally knows about them.

The American Health Information Management Association (AHIMA), in partnership with ImplementHIT, has announced the launch of its latest ICD-10 training solution, the Clinical Documentation for ICD-10 by Specialty: Principles and Practice modules.