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4 Medical Billing Issues Affecting Healthcare Revenue Cycle

By Jacqueline Belliveau for RevCycle Intelligence Addressing these four common medical billing challenges can have a positive impact on the healthcare revenue cycle. Medical billing is the backbone of healthcare revenue cycle management, but many providers experience significant challenges with efficiently and accurately billing patients and payers for services they perform. The medical billing process…

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What to Know About Medicare’s Big Bundled-Payment Expansion

By Elizabeth Whitman for Modern Healthcare A new mandatory program the CMS proposed Monday would make hospitals in 98 markets financially accountable for the cost and quality of all care associated with bypass surgery and heart attacks. “We think it’s important to keep pushing forward on delivery system reform,” Dr. Patrick Conway, acting principal deputy…

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Feds Charge 3 People in Record $1 Billion Medicare Fraud Scheme

By Sarah N. Lynch for MSN Money The U.S. Department of Justice unveiled its largest-ever criminal healthcare fraud case against individuals on Friday, charging the owner of Miami-based assisted living facilities and two others in a massive $1 billion Medicare fraud scheme. Prosecutors alleged that Philip Esformes, 47, “masterminded and executed a sophisticated health care…

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Health System to Pay $5.55 Million in Largest Ever HIPAA Settlement

By Emily Mongan for McKnight’s A major Illinois healthcare system will pay $5.55 million to settle allegations of HIPAA noncompliance, marking the largest settlement to date against a single entity, officials said. The allegations against Advocate Health Care Network, which operates 12 acute-care hospitals and more than 400 other sites of care across the state, involve…

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EHR-Enabled Fraud Remains a Concern

By Cheryl Branche for Medical Economics Imagine, in an effort to bill a higher fee, a colleague cuts and pastes a complete history and physical examination you wrote in the electronic health record (EHR) of your patient, but forgets to make adjustments based on his/her findings. This is happening with EHRs in hospitals and practices nationwide. While…

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AHIMA Identifies 5 Recurrent Mistakes in ICD-10 Coding

By Brooke Murphy for Becker’s Hospital CFO As coders grow and mature in their knowledge of and experience with ICD-10, it’s critical hospital administrators recognize best practices and pinpoint coding deficiencies for continued improvement. H.I.M. ON CALL chairman and CEO Manny Peña and CIOX Health coder Tammy Ree shared with the American Health Information Management…

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Damned If You Do, Damned If You Don’t

By Mac McMillan for Healthcare Informatics Last week I saw two ugly scenarios play out that did nothing positive for healthcare or its mission to protect patient information. The first incident involved escalations of the cyber threats healthcare organizations face. We were introduced to the hacker “The Dark Overlord” who had hacked multiple hospitals and…

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Did U.S. Technology Gap Push Medical Errors Into 3rd Leading Cause Of Death?

By Donald Voltz, MD for Health IT Outcomes Hardly a day goes by without some new revelation of a U.S. IT mess that seems like an endless round of the old radio show joke contest “Can You Top This” except, increasingly, the joke is on us. From nuclear weapons updated with floppy disks to needless medical…

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Coding and the Third-Party Option

By Selena Chavis for For The Record As outsourcing models gain a foothold, health care organizations weigh the pros and cons. Outsourced models are increasingly recognized as an attractive and viable option for a number of operational areas within health care organizations. In line with this trend, many organizations are considering the potential of moving either…

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