Come to Expect the Best

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MIPS and Alternative Payment Models (APM)

In an earlier post, we reviewed the 5 things you need to know about the Merit-based Incentive Payment System (MIPS). The MACRA bill that introduced the MIPS program also provides incentives for participation in Alternative Payment Models (APM) in general and bonus payments to those in the most highly advance APMs. We detail the particulars of these incentives in this blog post.

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How to Survive High Deductible Season: Collecting Patient Payments

It’s a new year, which means it’s time for a new deductible season. January is the time most insurance companies restart the calculation of annual deductibles for their members. This resetting of annual deductibles means a significant increase in patient responsibility for many practices. To ensure you are collecting on these patient owed balances, practices will need to employ every effort

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Understanding a Patient’s Rights to Protected Health Information

In an effort to ensure that consumers are able to rightfully access their health information, the Health and Human Services Department released new guidance on the HIPAA Privacy Rule. The guidance covers information such as patients’ general rights to their protected health information, what data is excluded from that right to access, how an individual may request access and how an entity must provide the information, among other topics.

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Industry Trends Impacting RCM in 2016

Higher out-of-pocket costs, new reimbursements models, and rising operating costs are just a few of the trends that will impact provider revenue cycles in 2016. These industry developments will force providers to evaluate existing and possibly implement new technologies and workflows to simultaneously maintain financial health and address evolving consumer and regulatory demands.

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Value-Based Payment Modifier: 2016 Medicare Physician Fee Schedule

In late October, the Centers for Medicare & Medicaid Services (CMS) issued Medicare Physician Fee Schedule Final Rule updating payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2016. CMS finalized a number of new policies including a set of provisions designed to provide a smooth transition from the Value-Based Payment Modifier (Value Modifier) to MIPS.

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Advance Care Planning: 2016 Medicare Physician Fee Schedule

In late October, the Centers for Medicare & Medicaid Services (CMS) issued the 2016 Medicare Physician Fee Schedule Final Rule updating payment policies, payment rates, and quality provisions for Medicare services furnished on or after January 1, 2016. The ruling covers a wide range of topics including a number of new policies, payment provisions as well as several quality provisions including updates to the Physician Quality Reporting System (PQRS) and the Physician Value-Based Payment

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ICD-10 Arrives

As the east coast braces for Hurricane Joaquin, the US healthcare system has just been hit by a tsunami of code changes. Today, doctors, hospitals and health insurers must start using a new diagnosis code set fondly known as – ICD-10. There is much trepidation surrounding the shift and many unknowns, but the change also brings with it many benefits.

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Advance Care Planning: 2016 Medicare Physician Fee Schedule

The transition to ICD-10 was touted as the Y2K of the healthcare industry. After years of preparation and training the industry held its breath as October 1st came and went. But, much like Y2K, the predicted disaster never happened. In fact, according to a , 80% of organizations believe they have had a smooth transition to ICD-10.

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