Changes coming in 2021 2020 looks to be a transition year on the payment front, as many programs and changes expected to go into effect this year have been delayed until 2021. These include new CMS-created primary care models and a streamlining of evaluation and management level-of-care coding. CMS announced in October its newest alternative […]
National Rural Health Center
https://www.ruralcenter.org/ Collaborating and innovating to improve the health of rural communities.
Clean Claim Rate (CCR) and First Pass Rate (FPR)
Two metrics important to the discussion of creating claims most likely to be immediately reimbursable are Clean Claim Rate (CCR) and First Pass Rate (FPR). Though sometimes confused for one another, these are separate statistics, each worthy of optimization. HFMA identifies the value of CCR as an indicator of the quality of data collected and reported. […]
IDN definition
An Integrated Delivery Network (IDN) is a formal system of providers and sites of care that provides both health care services and a health insurance plan to patients in a defined geographic area. The functionalities included in an IDN vary, but can include acute care, long-term health, specialty clinics, primary care, and home care services—all […]
MCH sees major issues with Cerner medical record system conversion
MCH sees major issues with medical record system conversion http://m.oaoa.com/news/government/ector_county_hospital_district/article_e34d7c74-bbf7-11e7-9e24-bfe4d7a66390.html?mode=jqm Sent from my Verizon, Samsung Galaxy smartphone
HFMA podcasts
Monthly podcast from HFMA http://www.hfma.org/podcast/ Sent from my Verizon, Samsung Galaxy smartphone
EAPG
Blue Cross Blue Shield Enhanced Ambulatory Patient Grouping (EAPG) methodology for calculating reimbursement for outpatient procedures http://www.okoha.com/OHA/Hotline/2015/April15/Taking_charge_of_the_EAPG__Improve_your_negotiations_with_BCBS.aspx
Hospitals typically leaving $22M on the table
Read this report from the Advisory Board on ways you can improve revenue cycle performance now. Hospitals leaving $22M on the table
Link to Medicare Quality Payment Program home page
https://qpp.cms.gov/
Core Quality Measures
Overview There is a great demand today for accurate, useful information on health care quality that can inform the decisions of consumers, employers, physicians and other clinicians, and policymakers. This is increasingly important as the health care system moves towards value-based reimbursement models. It is difficult to have actionable and useful information because physicians and […]
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