Results for Medical Coding

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Accurate medical coding is the lifeblood of financial viability for health systems and physician groups. Yet, nearly 15% of all claims submitted to private payers are initially denied, including many that were preapproved during the prior authorization process. 15.7% of Medicare Advantage and 13.9% of commercial claims were initially denied. ...Read More
Earlier this month, the Department of Health & Human Services released its final rule entitled the “21st Century Cures Act: Interoperability, Information Blocking and the ONC Health IT Certification Program.” The rule prohibits any activity that limits or inhibits the use, exchange or access of electronic health information (EHI). The ...Read More
As if “routine” healthcare operations aren’t challenging enough – operating a major health system during a potential global pandemic like we’re seeing now with COVID-19 – is even more difficult. Organizations have to consider dozens of critical functions, including communicating with staff and key stakeholders, surge planning and preparedness, implementing ...Read More
Computer-assisted coding (CAC) has been around since before ICD-10 was introduced – and was developed approximately 15 years ago as a tool to enhance manual coding processes with many promises of grandeur. Today, it’s a growing and emerging market – estimated to reach $4.1 billion globally by 2025, but the ...Read More
The State of US Hospitals Shrinking profit margins, reducing reimbursement rates and the uncertainties of healthcare reform have made operating a hospital a very risky business. Consolidation of small, rural hospitals into larger system has helped save many struggling hospitals, but others continue to lose money despite their best efforts ...Read More
The administrative costs associated with medical billing outsourcing within a physician practice are becoming unmanageable for independent and major health system affiliated practices alike. A 2018 research study was conducted by experts at Duke University and Harvard designed to examine the administrative costs specific to large academic medical centers using ...Read More
Declining reimbursements are one of the biggest challenges healthcare providers face today. Ask any physician or hospital and they will tell you about the daily struggle of getting paid for their services. However, many healthcare providers are leaving a significant amount of money on the table by under coding. (more…)Read More
Outsourced medical coding's traditional approach has been staff augmentation. It has been typically used to meet short-term gap needs due to turnover, extended absences, or electronic medical record (EMR) changes. In other words, it has been used when a healthcare provider needed temporary additional resources to supplement its existing resources. ...Read More
Now that the transition date for ICD-10 has been finalized – again! Don’t let concerns about severe reductions, or even the complete stoppage of your revenue stream caused by potential ICD-10 coding errors and slowdowns in your coding productivity keep you awake at night. There are reasons to be concerned, ...Read More
Medical Coding Outsourcing Provides Solution to Backlogged Coding Rejections INTRODUCTION A leading provider of medical billing services and solutions for hospital-based doctors and medical practices that serves more than 3,000 hospital-based physicians across the nation faced a severe financial challenge in the form of coding rejections. The practice management company ...Read More
In the face of today’s uncertain healthcare financial environment brought on by the effects of the American Recovery Reinvestment Act (ARRA Public Law 111-5) and Health Information Technology for Economic and Clinical Health Act (HITECH) and the House and Senate’s versions of the Affordable Healthcare Act for America, how can ...Read More