by admin | Dec 30, 2019 | Billing Terms, Codes, Denials Management, Patient Billing
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...
by Ed Slingsby | Apr 23, 2018 | Acronyms, Billing Terms, Uncategorized
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...
by admin | Jul 10, 2017 | Accronyms, Acronyms, BCBS, Billing Systems, Billing Terms, Insurance Claims, Patient Billing
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 Share...
by Ed Slingsby | Dec 9, 2016 | Billing Terms, Coding, Edits
NCDs (National Coverage Determinations) and LCDs (Local Coverage Determinations) are decisions by Medicare and their administrative contractors that provide coverage information and determine whether services are reasonable and necessary on certain services offered by...
by admin | Oct 13, 2016 | Acronyms, Billing Terms
Enterprise Resource planning Enterprise resource planning (ERP) is an industry term for the broad set of activities that helps an organization manage its business. An important goal oF ERP is to facilitate the flow of information so business decisions can be...
by admin | Sep 3, 2014 | Acronyms
Here are some definitions for acronyms that may be helpful: http://bcbsmi.net/providers/help/faqs/medicare-advantage/provider-toolkit/acronym-list.html Acronym Definition ABN Advance beneficiary notice AIM American Imaging Management ASF Ambulatory surgical facilities...
