In Audit
Sep 2nd, 2019
Ensure your organization receives credit for its chronically ill patients where credit is due. Requests for medical records come from many sources for different reasons. One reason is for quality assessment review of clinical documentation by contractors paid by the Centers for Medicare & Medicaid Services (CMS) for hierarchical condition category (HCC) and Healthcare Effectiveness ...
Two questions put risk adjustment into perspective on how it affects coding and physician payment. If you wonder what exactly risk adjustment is, how it impacts coding, and why it has become an important part of diagnosis coding, we have answers. What Is Risk Adjustment? Risk adjustment is basically a tool that determines how much ...
Achieve better clinical outcomes, higher rankings, accurate reimbursement, and improved patient health. If you work for a healthcare provider organization, you’ve probably heard of value-based care — perhaps, your organization is already in a value-based reimbursement contract. The transition from fee for service to value-based care means an increased focus on office and administrative efficiency. ...
In Coding
Feb 27th, 2019
Different interpretations of ICD-10-CM coding leave you at risk for improper quality scores and payment. Medical record auditors see a wide range of interpretation among coders and medical organizations regarding when and how overweight, obesity, and morbid obesity diagnosis should be abstracted from records, and regarding body mass index (BMI) reporting. These variances can potentially ...
A 7 percent payment update in your professional claims is at stake. That’s a nice bonus on top of the automatic 0.5 percent update to the Physician Fee Schedule (PFS). This is the last year for the automatic update, however. The only shot clinicians have at a PFS payment update in 2020 and beyond is ...