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Category: Healthcare Services

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Feasibility Studies: Helping Organizations Make Informed Decisions

Conducting a feasibility study is an essential step in determining the viability of implementing a new healthcare program, service, or project. These studies help healthcare organizations assess the potential risks and benefits of their proposed projects before investing significant time, money, and resources into planning for them. Feasibility Studies 101 Feasibility studies typically involve an […]

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2023 E/M Coding Changes You Need to Know from the Physician Fee Schedule Final Ruling

New rules for reporting evaluation and management (E/M) services in most places of service took effect January 1, 2023. The coding and documentation revisions, adopted by the American Medical Association’s CPT Editorial Panel and approved by the Centers for Medicare and Medicaid Services (CMS), substantially simplify code selection and documentation. Effective January 1st, E/M services […]

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Consolidated Appropriations Act of 2023 Changes Impacting Rural Health Clinics

The Consolidated Appropriations Act of 2023, also known as the “Omnibus” package, was signed into law by President Biden on December 29, 2022. Rural Health Clinics (RHCs) need to be aware of some of the changes that will impact them including new grant opportunities and behavioral health provisions. Opportunities for Rural Health Clinics from the […]

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Medicare Bad Debt Listing Template Finalized by CMS

This article has been updated on January 5, 2023. Back in August 2022, CMS was proposing changes to the Medicare Bad Debt listing template that is filed with your organization’s cost report. The new template (Exhibit 2A) has recently been finalized by Medicare and is now required for cost reporting periods beginning on or after […]

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Neurosurgery Operations Assessment: Ten Opportunities for Improvement

In response to the COVID-19 pandemic, neurosurgery practices across the United States are looking for creative ways to remain independent in private practice while ensuring they meet the needs of the neurosurgical care demand within their communities. Physician owners, partners, and private practice executives often wonder whether a diagnostic “biopsy” of their practice can be […]

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Physician Fee Schedule: 2023 CMS Final Ruling

The Centers for Medicare & Medicaid Services (CMS) operates within a budget neutral approach. This occurs at the same time the healthcare community continues to try and find balance between reducing administrative burdens, accurately recognizing and recording services provided, and upholding the highest quality care possible. Over the last three years, there have been significant […]

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Infusions: Will your documentation pass a Targeted Probe and Educate Review?

For years, Blue & Co. has received questions from hospitals regarding coding and billing for infusions, as well as documentation requirements. Infusion coding can be some of the most difficult coding for hospitals. It takes a certain understanding of 1) the required hierarchy, 2) what happens if a stop time is not recorded, 3) how […]

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Five Steps to Build Successful Growth Strategies

In a post-pandemic environment, providers are more likely to refer patients for procedures, diagnostic testing, and physician visits to non-hospital environments. This presents an opportunity for healthcare leaders to re-exam their growth strategies and develop structure to define the market opportunity, redefine access as defined by providers and customers, and leverage data to prevent leakage […]

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Managed Care Contracting: Outdated Contracts Could be Costing Your Organization

A recent Blue & Co. audit of a small hospital’s existing Managed Care contracts yielded an unfortunate surprise: a nearly twenty-year-old contract with a major insurance company with rates that had not been updated since the original effective date. Not so surprisingly, these rates were woefully inadequate – reflecting a commercial rate that was only […]

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How Transparency and Patient Advocacy Can Reduce Your Hospital’s Bad Debt

In 2019 patient medical debt in the U.S. totaled at least $195 billion, according to an analysis by the Kaiser Family Foundation, a nonprofit organization focusing on national health issues. This is a massive figure and should be looked at as an opportunity for healthcare organizations. A survey conducted by Kaufman Hall in August 2020 […]

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Contract Services: Impact on Wage Index

In the past several years, hospitals have continued to feel the impact of increased utilization of contract nursing and other contract services. Although these services have developed into a major expense line item, it is important for hospitals understand how expenses related to contracted services can impact the wage index factor for Medicare reimbursement. Contract […]

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shamrocks not-for-profit tips

3 Lucky Tips for Not-For-Profits to Avoid Bank Fraud

Trusted Insights from The National Bank of Indianapolis Nonprofit Services Team Not-for-profit organizations are increasingly falling victim to fraud, with a rising number of incidents and an ever-growing amount of money being lost. Fraudsters find it easy to target not-for-profits, as their publicly available 990s provide valuable information. Protecting your organization from such fraudulent activities […]

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Capital Efficiency Concepts: How to Evaluate Capital Purchases

Rising interest rates and historic inflation are impacting hospital purchasing decisions. Using capital efficiency concepts in making hospital purchasing plans is as important as ever. What is Capital Efficiency? Capital efficiency refers to how effectively a hospital deploys its resources to generate returns. In the context of fixed assets and software purchases, capital efficiency involves […]

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