Perhaps the most vulnerable of issues in the Revenue Cycle Management process is the potential for incorrect information creation in a patient’s chart. Data disparities duplicate or inaccurate medical record number recording, and unverified insurance verifications processes in place can potentiate claim denials. Revenue Cycle Management can be thought of as the method of transportation to take an organization from one place to where it needs to go. For the transport to occur successfully and be operationally sound, the processes in place to support it must be accurate and deliberate.
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Year by year, organizations rely more and more on their data analytics. In this article you will be provided with: An overview of key statistics to include in your coding compliance audits, a Questionnaire to determine if you need a coding compliance audit program…
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As a follow-up to our previous article “The HCC Coding Specialist: Benefiting payers, providers, and patients” we now delve in deeper to the background and overview of HCC risk adjustment for the Medicare Advantage Program.
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The Agency for Healthcare Research and Quality (AHRQ) developed Patient Safety Indicators (PSI) to judge the quality of care at Hospitals. The data can be used:
- By patients to choose where they go for care
- Third party payers to select facilities to contract for services
- Assist QA departments identify potential problem areas
- Help leadership assess. monitor, track, and improve patient safety
- Determine financial gain or loss (CMS PSI 90, contract bonuses for quality)
Make Room for Exceptions: This years’ updates to the ICD-10-PCS Official Guidelines for Coding and Reporting include a new section, updates to an existing section, new guidance on a body part, some editorial changes and the introduction to the possibility of exceptions for special cases.
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