Coding


Codified data is the prerequisite for both health care billing and clinical documentation. Topics here include: ICD-10, the role of the HIM department in I.T. efforts, data formats and standards, participation in payer incentive programs and upholding regulatory requirements.


Fairly Shocking: The Feds as an Efficiency Leader?

Greg Gillespie | Feb 10
My father wasn’t the first or last to say that it will be a sad day indeed if the private sector ever gets lapped by the feds in terms of efficiency.
Group Practices
Payers

HIPAA 6020 Put on Back Burner, for Now

Joseph Goedert | Feb 07
Health care stakeholders struggling to comply with the HIPAA 5010 transaction sets need not worry about one thing-- the next-generation 6020 transactions are not coming to a theater near you any time soon.
Electronic Data Interchange
Revenue Cycle & Payments

AHIMA Readies its ICD-10 Summit

Joseph Goedert | Feb 07
The American Health Information Management Association will again hold its annual ICD-10 Summit, April 16-17 in Baltimore.
Document Management
EHR

Health Plan ID, Insurance Exchange Rules Coming Soon

Joseph Goedert | Feb 06
The Department of Health and Human Services expects soon to publish a final rule to govern establishment of state insurance exchanges to provide one-stop shopping for health coverage, and a proposed rule to establish the long-delayed unique identifier for health plans.
Policy & Regulation
Electronic Data Interchange

MGMA Asks HHS for More Time, Fixes to HIPAA 5010

Joseph Goedert | Feb 02
The Medical Group Management Association has sent a letter to HHS Secretary Kathleen Sebelius outlining significant problems with federal reimbursement of claims following the transition to the HIPAA 5010 transaction sets.
Electronic Data Interchange
Revenue Cycle Management

AMA to Sebelius: Stop ICD-10

Joseph Goedert | Feb 02
The American Medical Association, which is actively working to stop implementation of the ICD-10 code sets, has sent a letter to HHS Secretary Kathleen Sebelius asking her to immediately halt the implementation process.
Policy & Regulation
Stimulus

Rule Would Boost Payment for Primary Care

Joseph Goedert | Feb 02
The Centers for Medicare and Medicaid Services expects soon to publish a proposed rule that will have significant revenue ramifications for primary care physicians.
Group Practices
Hospitals

5010 – Ready or Not, Here It Comes (Part 3 of 3)

Jackie Griffin | Jan 31
There is absolutely no denying it now – HIPAA 5010 is here, and we’re all feeling the weight of it. Over the past few weeks, I’ve been presenting on 5010 with associations and talking with representatives from all different areas of the industry to get a feel for the main points of pains that are out there.
Electronic Data Interchange
Policy & Regulation

GAO: Medicare Overpaying for Medicare Advantage

Joseph Goedert | Jan 31
A study by the Government Accountability Office finds differences in diagnostic coding between Medicare Advantage plans and traditional Medicare fee-for-service coverage.
Payers
Revenue Cycle Management

AHIMA: AMA Stance on ICD-10 Should Not Slow Down Work

Joseph Goedert | Jan 30
With the American Medical Association ramping up its fight against the ICD-10 code sets by asking House Speaker John Boehner for assistance in stopping mandated implementation, the American Health Information Management Association is warning against slowing down compliance work.
EHR
Electronic Data Interchange

AMA Asks Speaker Boehner to Kill ICD-10

Joseph Goedert | Jan 26
The American Medical Association is asking House Speaker John Boehner to help stop implementation of the ICD-10 code sets and call on the industry to assess an appropriate replacement for ICD-9, The Hill newspaper reports.
Comments (3)
Electronic Data Interchange
EHR

Conference Call to Update CORE Rules for HIPAA Transactions

Joseph Goedert | Jan 19
A free Town Hall call on the CORE operating rules to tighten the HIPAA administrative and financial transactions, which are mandated under the Affordable Care Act, is scheduled on Jan. 24 at 3 pm Eastern Time.
Electronic Data Interchange
Payers

Survey Tracks How Providers Handle RAC Audits

Joseph Goedert | Jan 19
A new survey of 418 provider organizations finds that responsibility for handling audits under the Medicare Recovery Audit Contractor program falls to the compliance department for two-thirds of respondents. The two-thirds market was consistent for organizations of various sizes, with the exception being those with 250 or fewer employees, which have the compliance department handling RACs nearly 75 percent of the time. …
Revenue Cycle Management
Hospitals

New Tools for Physicians on AMA Web Site

Joseph Goedert | Jan 12
The American Medical Association has enhanced its Practice Management Center Web site for members and nonmembers.
Electronic Data Interchange
Revenue Cycle Management

ED Vendor T-System Buys Billing Firm

Joseph Goedert | Jan 11
Emergency department information systems vendor T-System Inc. has acquired outsourced billing firm Practice Management Associates for an undisclosed price.
Hospitals
Revenue Cycle Management
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