hospital billing

Does the United States Need a National Hospital Billing Data Set?

Patients’ experience in hospitals and hospital billing can vary significantly, even if two hospitals are just a few miles away from each other. In essence, the American patient has no idea what their financial experience will be when they step into the hospital setting – they’re rolling the dice.

But a dedicated organization is trying to provide some transparency around the hospital billing and financial experience.

5 Signs Your Organization is Struggling with OASIS Coding

OASIS-E went into effect January 1, 2023, putting providers under pressure to keep up. While many home health providers are feeling comfortable with how they’ve adapted over the last year, this could be a false sense of security. Home health coding practices can be weighing on your organization without your knowledge. Thankfully, there are signs you can look out for to identify where you might be struggling and where you might need to

8 Signs You Should Invest in a Medical Coding Audit before 2024

All the change in healthcare over the recent years has unfortunately meant new opportunities for abuses of medical billing. This kind of fraud and misuse puts providers at risk financially and ultimately jeopardizes the quality of care you can provide in the long term. Many providers who have realized this understand that now is a good time to consider investing in medical coding audits. If you begin the process now,

Why Medicare Advantage Plans and ACOs Need Experienced Vendors to Prepare for CMS-HCC Version 28

Medicare Advantage (MA) plans and Accountable Care Organizations (ACOs) should be reevaluating their vendor strategy in light of coming changes. 

This is largely because of a new version of the Hierarchical Condition Category (CMS-HCC) risk adjustment model that CMS released in 2023. It includes changes that will enhance the value of partnering with an experienced vendor for in-depth retrospective and concurrent risk adjustment reviews. Leaders at these organizations will benefit from

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