The Five Foundational Elements of an Effective Inpatient Coding Compliance Program
/ Posted in Gebbs HealthcareDeveloping and maintaining a strong inpatient coding compliance program is critical for health systems of all sizes. Constantly changing guidelines, regulations, policies and standards make it important to have a comprehensive process in place for continuing to monitor your organization’s compliance. Failure to do so can have lasting implications on your revenue cycle and could …
Why ‘Audit’ Isn’t a Four-Letter Word When It Comes to Medical Coding
/ Posted in Gebbs HealthcareJust the sound of the word “audit” may leave some leaders feeling uneasy, but the value of an effective medical coding audit strategy can’t be underestimated for healthcare organizations of all sizes and specialties. It not only provides an opportunity to ensure your practice or healthcare organization is following important regulations and guidelines, but it …
What’s Up With MIPS? New MVPs Framework Could Bring Sweeping Changes
/ Posted in Gebbs HealthcareThe Merit-based Incentive Payment System (MIPS) – which is just one element of the government’s proposed alternative payment models (APMs) designed to reduce healthcare costs – has been a moving target since the concept was introduced in 2015. Just last week, the Centers for Medicare & Medicaid Services outlined a new proposal to its Medicare …
The Do’s and Don’ts of Partnering With an HIM Vendor
/ Posted in Gebbs HealthcareThe decision to outsource your HIM functions represents a major operational decision – but one that can bring great value to healthcare organizations of all sizes. To do it, you’ll need to invest time and resources into the arrangement, so it’s important to be thoughtful throughout the process. So, when it comes to outsourcing your …
AI – Enhancing the Future of Medical Billing & Coding
/ Posted in Gebbs HealthcareThe 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 to cut costs. In fact, …
Rev Up Your Revenue Cycle with AI
/ Posted in Gebbs HealthcareWith profit margins shrinking and the cost of health care going nowhere but up, operational leaders and consultants throughout the healthcare industry are looking in every nook and cranny to either find ways to cut costs or generate more revenue. With the ongoing need for costly equipment, an expert workforce and the state-of-the-art facilities needed …
Risk Adjustment Meets Artificial Intelligence – A Perfect Match
/ Posted in Gebbs HealthcareBig data is all the rage – transforming industries from tech to retail and much more. Healthcare – an industry slow to adopt technology in many ways now has access to more data than ever before with the widespread adoption of electronic health records (EHRs). But, what do we do with all this data in …
It’s Working – CMS Report Concludes the Effectiveness of Risk Adjustment
/ Posted in Gebbs HealthcareIn late June, the Centers for Medicare & Medicaid Services released data demonstrating that its Risk Adjustment Program – developed as part of the Affordable Care Act just five years ago – is working just as planned. What was the plan? To prevent payers from developing plans intended to attract healthier patients and to incentivize …
The #1 Most Critical Driver in the Successful Adoption of Shared Risk Programs
/ Posted in Gebbs HealthcareThe unavoidable shift toward value-based and two-sided risk payment models is here to stay – and while the benefits are countless, the journey thus far has been slow and somewhat painful for payers, providers and healthcare organizations alike. Healthcare is one of the slowest industries to effectively adopt technology and the reasons for this are …
Strategies for Mastering Two-Sided Risk
/ Posted in Gebbs HealthcarePopulation health and the transition to two-sided risk is no easy feat – it’s a monumental shift in the way providers, payers and hospitals think about the delivery of health care. And, while, we all know it’s coming – knowing how to get there and doing it successfully is the real challenge. While most accountable …