Posts Tagged ‘medical billing’
Medical Coding and Billing: Understanding Their Differences and Similarities
Medical coding and billing are often discussed together, but they represent two distinct processes. Both roles are critical to ensuring healthcare providers get reimbursed for their services, but they require different skill sets, training, and responsibilities.
Read MoreDifferentiating Between IPPE (G0402), AWV (G0438/G0439), and Annual Physical (99381-99397)
Medicare offers various preventive services to help beneficiaries maintain their health. Understand the differences between the Initial Preventive Physical Examination (IPPE), Annual Wellness Visit (AWV), and the routine annual physical exam.
Read MoreProfessional Fee Coding is the Next Big Risk to Your Organization – Eliminate These Risks to Save Your Bottom Line
The risks of inaccurate professional fee coding could be detrimental to your organization’s revenue and overall success. Follow these steps to eliminate those risks and save your bottom line.
Read MoreHow to Improve the DNFB Benchmark for a Positive Impact on Revenue Cycle
One of the biggest revenue-killers for healthcare providers is DNFB accounts. DNFB (DNFB meaning “discharged, not final billed”) – defines unbilled accounts where the patient has been discharged from the healthcare facility, but the final bill from the encounter has not been submitted. The cost effects of outstanding DNFB accounts and claims denials are staggering, and can negatively impact the providers’ cash flow and potential net revenue. So, what are the best practices to reduce DNFB days and claims denials?
Read More“Does Your Documentation Meet the M.E.A.T. Criteria?” Presentation by Karen Youmans at 2021 Southeastern Health Data & Information Conference
“Does Your Documentation Meet the M.E.A.T. Criteria?” Presentation by Karen Youmans at 2021 Southeastern Health Data & Information Conference (Quad21) Karen Youmans’ presentation at the Quad21 (Southeastern Health Data…
Read MoreLatest COVID-19 News: Review Our Resource Center for Coronavirus Coding & Billing Updates
The outbreak of COVID-19 led to many unprecedented changes for the healthcare industry. Review this collection of latest COVID-19 news, coding guidelines, and other resources to ensure your coding team stays compliant.
Read MoreMaking the Data Work for You: How to Turn Medical Coding Audits into Actionable Insights
Coding audit data can be extremely beneficial to the success of a healthcare organization – however, oftentimes, the vast amounts of data being collected can suffocate the organization, especially those that don’t know how to cultivate value and act on the insights received from the audit process.
Read MoreTelehealth Resource Center for Revised PHE Coding & Billing Policies Due to COVID-19
The Center for Medicare & Medicaid Services (CMS) expanded the payment guidelines for professional telehealth services provided to Medicare beneficiaries during the Public Health Emergency (PHE) declared for COVID-19 (CMS, 2020). The temporary protocol expansion was deemed necessary to aid healthcare reimbursement, and will be active only during the PHE. To keep coders and auditors up-to-date on the expanded services and reimbursement guidelines, YES HIM Consulting has gathered all the latest updates to form a telehealth resource center.
Read MoreEverything You Need to Know About the HCC Risk Adjustment Models
There are two different models for Hierarchical Condition Category (HCC) risk adjustments: the HHS-HCC model, which covers commercial payers of all ages and determines risk payments for the current year, and the CMS-HCC model for the Medicare Advantage program and those who qualify for Medicare or patients 65 and older.
Read MoreReview the ICD-10-PCS 2021 Updates, Effective 10-1-2020
This article will highlight the ICD 10 PCS 2021 updates and Guideline changes, and briefly present some of the code additions for the Medical and Surgical Section.
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