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,
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
Revenue cycle management has grown to an unmatched level of complexity in recent years. For most organizations, this has meant increased needs for training and improved hiring processes – but is it possible there’s a limit to the effectiveness of these tactics?
If you take a close look at the requirements of many revenue cycle roles, you’ll likely find something interesting. A select few are so complex, that they require looking outside the organization for expertise to access a higher level of performance in revenue cycle management services. These are typically positions that have
In the wake of COVID, budget crunches, and labor shortages, many hospitals and health systems have been making the smart decision to rethink their service lines. But what many haven’t had the space to consider is the impact on hospital billing, hospital coding, and how their
With Q4 of 2023 coming around the corner, it’s time to start looking at plans for 2024. It might not seem like it should make your short list of priorities, but medical coding audits should be on the mind of your leadership team today – specifically looking for ways to get in front of them.
Healthcare providers will be in a much better position next year if they take the remainder of 2023 to step back, look for current issues, and devise ways to prevent and respond.
