Claims Processing
The offical transition to the ICD-10 coding set takes place next October (or so we hope). Many providers have already spent a good deal of money preparing for the inevitable, but even so, you need to make certain that select ICD-10 costs are included in your 2015 budget.
Some health systems see value in becoming part of branded health plan networks for limited provider plans, as other providers try to launch their very own plans.
With an annual rate of 11,000 fatalities from falls in U.S. hospitals, falls are a persistent concern for healthcare facilities. They raise issues of care quality and are increasingly a financial issue.
A Mississippi health system and three hospitals in Texas, Indiana and Alabama are illustrating how hospitals can thrive in a tough economic environment. The facilities recently won awards for their leadership in initiatives to improve financial sustainability and achieve significant financial performance improvements.
With patients paying more out-of-pocket costs and exchanges increasing the number of plans providers deal with, having financial counselors in a practice may become a necessity.
Medicare announced Friday that it was revising rules intended to prevent the agency from paying twice for the same prescriptions for seniors receiving hospice care. The drug categories in question were identified in a 2012 investigation by the HHS inspector general.
If your modus operandi is to appeal all denied claims, you may want to reconsider because some claims are not worth it.
Of the states that built their own health insurance exchanges that are now operational, Washington, Kentucky and Minnesota enjoyed some successes that might be replicated.
The American Hospital Association is asking federal Medicare leaders to stem the practice of using sample hospital audit data to extrapolate overpayments eligible for recovery. The lack of clarity regarding standards for short patient stays has clouded the issue.
A group of chiropractors went to war with the Blues and it seems they've won, successfully using a novel legal theory that now has lawyers setting their sights on other large insurers.