YES HIM Consulting, Inc. Your Consulting Firm for Auditing, Coding and Education

Health Information Management

MEAT Criteria

HCC Chronic Conditions and M.E.A.T. Criteria

By Karen Youmans / January 13, 2020 / 0 Comments

As a follow-up to our previous articles “The HCC Coding Specialist: Benefiting payers, providers, and patients” and “HCC Medicare Advantage background and overview,” we now review HCC chronic conditions and the M.E.A.T. documentation criteria.

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CPT Updates

CPT Changes for 2020 – Part Two

By Teri Jorwic / January 10, 2020 / 0 Comments

CPT 2020 changes took effect on January 1, 2020. In Part 2, we continue with a discussion of revisions in the Evaluation and Management, and Medicine sections, along with an overview of updates in the Radiology, Pathology and Laboratory, and the new Category III codes.

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Medical Data

Is Your Medical Data At Risk? – Part Two

By YES HIM Consulting / January 8, 2020 / 0 Comments

As a follow-up to our previous article, “Is Your Medical Data At Risk? – Part One,” we now examine how personal health information could be used in the hands of technology companies outside of the medical industry. Representatives from Google and Ascension have said the medical data will be used solely to develop software that will make suggestions for patient care.

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ICD-11

ICD-11 Overview

By Karen Youmans / January 6, 2020 / 0 Comments

The World Health Organization (WHO) recently released the 11th edition of the International Classification of Diseases (ICD-11). This release was presented at the World Health Assembly on May 25, 2019 for adoption by member states, and will come into effect on January 1, 2022. However, note that it is still unknown when ICD-11 will be ready for implementation in the United States.

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Fiscal Year

End of The Fiscal Year Push!

By John Franz / December 31, 2019 / 0 Comments

Every organization associated with Health Information Coding has felt the pressure to catch everything up at the end of the Fiscal Year. It helps to understand what is at stake and how you can help. Some Fiscal Years (FY) correspond to the calendar year, while others start/end at times established for taxing and accounting purposes. Annual Financial reports are generated during this time to show the success or failure of the organization to meet its goals and expectations.

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2020 CPT Code Changes

New Year, New Codes: CPT Changes for 2020

By Teri Jorwic / December 30, 2019 / 0 Comments

As we turn the calendar to a new decade, the 2020 CPT code changes take effect. This year there are a total of 394 changes to CPT, bringing the total number of codes to 10,471. This includes 248 new codes, 71 deletions, and 75 code revisions, according to the American Medical Association (AMA). This is Part 1 of a 2-Part Series. In this article, we will discuss the changes in the Surgery Section.

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Medicare Advantage

Medicare Advantage Insurers Use Reviews to Get Higher Payments

By YES HIM Consulting / December 20, 2019 / 0 Comments

An investigation by the Office of Inspector General (OIG) revealed Medicare Advantage insurers might be overstating patients’ diagnoses without the proper documentation to receive larger payments. Based on the 2016 Medicare Advantage encounter data analyzed by the OIG, insurers were able to get an extra $6.7 billion in payments in 2017.

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strategic planning

Crafting Your Organization’s Strategic Plan For A Successful Year

By YES HIM Consulting / December 18, 2019 / 0 Comments

The healthcare and health information management industry is no stranger to constant changes and evolutions. To successfully navigate the future – and be prepared for anything – healthcare organizations need to craft a strategic plan. A strategic plan is beneficial for everyone: It allows the company owner to identify which goals will help grow the organization, and it helps the employees foster that growth by accomplishing the necessary objectives and increasing productivity.

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Optimal Quality Coding

Optimal Quality Coding Prevents Medical Claims Denials

By YES HIM Consulting / December 16, 2019 / 0 Comments

Medical billing denials generate significant cost for providers and hospitals that could be avoided by improving claims data management and optimizing medical coding processes. Optimal quality coding effectively prevents medical claims denials by reducing the potential for manual error and addressing concerns over fast approaching time limits.

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Revenue Cycle Management

Clinical Documentation Integrity Significance in Revenue Cycle Management Success in Healthcare

By Mari Cely / November 6, 2019 / 0 Comments

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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YES HIM Consulting, Inc. Largo, Fl.
Office: (727) 531-3839       Fax: (727) 240-4592