Encounter Data…Why Getting It Right is More Important Than Ever

Posted in Coding Accuracy, Medical Coding, Remote Medical Coding

Earlier this month, CMS announced changes to future payments for Medicare Advantage plans that will take effect in 2020. While a pay raise is part of the plan, what’s causing a stir is that payment will now be based on a higher percentage of patient encounter data (up to 25% from 10%). Many (especially payers) have argued that encounter data is often incomplete and inaccurate when compared to diagnoses, since encounter data relies on provider documentation.

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Coding Denials “Wait and See What Happens” Will NOT be a Good Strategy When the ICD-10 Grace Period Ends!

Posted in Medical Coding, Medical Coding BPO, Outsource Coding, Remote Medical Coding

The Centers for Medicare & Medicaid Services’ (CMS) grace period for denials of claims under ICD-10 will end on October 1, 2016. Healthcare providers and billing companies must be prepared for this deadline and its financial effects. When CMS instituted the new ICD-10 program last year, it announced that Medicare claims would neither be denied …

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CMS Chronic Care Management (CCM) Initiative Can Help Improve Bottom Line for Physicians

Posted in Business Process Outsourcing (BPO), Coding Outsourcing, Medical Coding BPO, Medical Coding Outsourcing, Offshore Medical Billing, Offshore Medical Coding, Offshore Revenue Cycle Management, Outsource Coding, Outsourced Medical Billing, Outsourced Medical Coding, Remote Medical Coding

In today’s healthcare delivery environment, physicians are constantly looking for new ways to earn and increase their bottom lines. For example, the 2015 Medicare Physician Fee Schedule (PFS) will pay for non-face-to-face services for CPT code 99490 — Chronic Care Management (CCM), which reimburses practices on an average of $42 per patient, per month. Of all …

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Medical Coding Outsourcing is More Than Staffing

Posted in Business Process Outsourcing (BPO), Coding Accuracy, Medical Coding BPO, Medical Coding Outsourcing, Offshore Medical Billing, Offshore Medical Coding, Offshore Revenue Cycle Management, Outsource Coding, Outsourced Medical Billing, Outsourced Medical Coding, Remote Medical Coding

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. However, from our experience, this …

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Survey Shows About 80 Percent of Hospital CFO’s Consider Outsourcing RCM to be the Best Stop-Gap Measure

Posted in Business Process Outsourcing (BPO), Healthcare BPO Companies, Healthcare Revenue Billing, Knowledge Process Outsourcing (KPO), Medical Coding, Medical Coding Outsourcing, Offshore Medical Billing, Offshore Medical Coding, Offshore Revenue Cycle Management, Outsource Coding, Remote Medical Coding, Revenue Cycle Management (RCM)

By Nitin Thakor, GeBBS President & CEO According to a recent survey reported in Healthcare Finance, 83 percent of hospitals now outsource some accounts receivable and collections, 58 percent of hospitals outsource some contract management, 55 percent of hospitals outsource some denials management and 68 percent of physician groups with more than 10 practitioners now …

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Top 10 Reasons Why You Should Outsource Your Revenue Cycle Activities

Posted in Affordable Care Act, Business Process Outsourcing (BPO), Insurance Billing Solutions, Medical Billing BPO, Medical Coding, Medical Coding BPO, Offshore Medical Billing, Offshore Medical Coding, Offshore Revenue Cycle Management, Remote Medical Coding, Revenue Cycle Management (RCM)

In today’s healthcare environment of shrinking reimbursements, due to governmental mandates and Medicare policy changes, the importance of maintaining a healthy revenue cycle is second only to providing the best patient care possible. Without an adequate margin there can be no medical mission. One way to ensure your revenue cycle remains as healthy as possible …

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