The concept of Hierarchical Condition Categories (HCC) is not new; CMS implemented the HCC model in 2004 as a way to determine capitated payments for Medicare Advantage plans. With the number of patients enrolled in Medicare Advantage...Read More »
For the second year in a row, the Mayo Clinic tops the U.S. News & World Report’s “Honor Roll” of the best hospitals of 2017-2018, HealthLeaders Media reported.Read More »
Which types of clinicians will get “special status” from CMS for the Quality Payment Program (QPP) data submissions this year? CMS recently updated its website with a tool (available online) providers can use to check to see whether they are...Read More »
Researchers at NYU Langone found that many informal consultations between referrers and radiologists were captured incompletely or inadequately in the electronic health record (EHR), according to...Read More »
Although the transition to ICD-10-CM/PCS was fairly smooth, two years later billing and coding experts say that, in most cases, the codes are not being put to their intended use.Read More »
The Department of Justice (DOJ) and the Department of Health and Human Service Office of Inspector General announced on Thursday, July 13, charges against 412 individuals responsible for $1.3 billion in false billing. This fraud takedown is the largest in DOJ history,...Read More »
“One of the key components for a successful CDI program is the ability to review records concurrently […] Since the documentation takes place so rapidly in the outpatient world, though, concurrent review is difficult,” said Tammy Combs, RN, MSN, CDIP, CCS, CCDS, director and lead nurse planner...Read More »