Mapping ICD-9 to ICD-10 ‘Convoluted,’ Experts Say
Healthcare providers should plan for substantial disruption of billing and reimbursements upon switching to ICD-10 on Oct. 1, 2014, according to the results of an exhaustive study that attempted to map...
View ArticleDo Medicare Readmission Penalties Unfairly Target Safety-Net Hospitals?
Are safety-net hospitals unfairly burdened by the new Medicare penalties on facilities with higher relative readmission rates? Reading between the lines of a recent report by the California HealthCare...
View ArticleInspector General Wants CMS to Scrutinize G Modifiers
Within the arcane science that rules Medicare claims, there are the “G modifiers,” which providers use to notify Medicare that a particular bill may not qualify for reimbursement. But then Medicare...
View ArticleMaintaining Your Integrity through Healthcare Data Integrity
The main source of legitimate complaints about healthcare provider collections are mistakes, and almost always data errors. The more data errors you have, the lower the quality of your data integrity....
View ArticleCongress Agrees: Change How Healthcare Providers Get Paid
It may be too early to hold hands and sing “Kumbaya,” but leadership in the House of Representatives and Senate for once agree on something: We must change the way Medicare pays health providers. In...
View ArticleHospitals Sought to Test Bundled Payment
The Centers for Medicare and Medicaid Services (CMS) has reopened its search for hospitals interested in testing a bundled payment model. On Friday CMS published notice in the Federal Register that it...
View ArticleCMS Publishes Formula Cutting Disproportionate Share Hospital Reimbursement
Last week’s the Obama administration made noises about postponing cuts to disproportionate share hospitals, but when the regulations came out, the cuts were there in black and white. The new...
View ArticleIPF on Forbes: Newly Insured No Boon to Physician Bottom Line
In this week’s blog post on Forbes.com, I write about the problems the newly insured will have finding healthcare, based on the results of ”Practice Profitability Index ,” a survey and analysis by...
View ArticleIPF on Forbes: Fight Medicare Fraud Like Credit Card Companies
Over at Forbes.com you’ll find a high-level summary of the current state of the battle over Recovery Audit Contractors (RACs). While most healthcare providers are abreast of the latest developments,...
View ArticleHouse of Representatives Seeks Input on Bill Scrapping ‘Doc Fix’
Congress is preparing to eliminate the Sustainable Growth Rate (SGR, sometimes known as the “Doc Fix”) formula and wants to hear from healthcare providers and others if its proposed replacement is...
View ArticleMedicare Given Two More Years to Live
Medicare’s Board of Trustees announced last week that it has projected the program’s life will extend another two years to 2026 But as any physician knows, predicting how long someone will survive is a...
View ArticleHospitals Appealing RAC Denials in Record Numbers
Centers for Medicare & Medicaid Services (CMS) Recovery audit contractors (RACs) are denying more claims than ever, but hospitals are throwing those denials back at them in the form of an...
View ArticleAmerican College of Physicians Offers 19-Point Plan to Replace SGR
Last month the Senate Finance Committee called for stakeholders to provide recommendations to replace the Sustainable Growth Rate (SGR) formula, and last week the American College of Physicians weighed...
View ArticleYou’ve Selected an Outsource Partner for Your Conversion Project. Now What?
Editor’s Note: This article is the first in a two-part series by Roberta Schultz, a follow-up to her April story, “Don’t Let Your Billing System Conversion Break Your Revenue Cycle.” The second...
View ArticleFour Building Blocks to Bring Your Outsource Partner into the Fold
Editor’s Note: This article is the first in a two-part series by Roberta Schultz, a follow-up to her April story, “Don’t Let Your Billing System Conversion Break Your Revenue Cycle.” The first...
View ArticlePutting Context around Projections of Medicare Health
Medicare’s projected solvency may have been extended two years to 2026, but the consensus among pundits and even Medicare’s Board of Trustees is that it is a best guess based on shaky assumptions....
View ArticleHundreds of Doctors Involved in Medicare Scam, Lab President Claims
Hundreds of doctors in New York and New Jersey allegedly conspired with a medical laboratory to defraud Medicare, the president of that laboratory told the NBC affiliate in New York. Scott Nicoll,...
View ArticleCriticism of NYT Story on Colonoscopy Prices Rolls In
Last week’s New York Times article that attempted to make colonoscopies the poster child for the high cost of healthcare in the United States received a failing grade from the healthcare industry. Last...
View ArticleThe Five Must-Haves When Selecting a Medical Debt Collection Partner
Your relationship with your healthcare collection partner is like a marriage, and it is not unusual for a healthcare provider and collection partner to have been together for years. But there will come...
View ArticleBusting the Myth About Money Behind Lab Tests
Doctors who have no financial incentive to order laboratory tests will send their patients to the lab as often as those who do, a new study has found. Researchers at the Malcom Randall Veterans Affairs...
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