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Category: Healthcare Services

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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Managed Care Contracting: Outdated Contracts Could be Costing Your Organization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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Proposed Updates to Medicare Bad Debt Listing Template

Recently there have been conversations around the potential new template from CMS that will be used for the Medicare Bad Debt listing that is filed with your organization’s cost report. As of July 2022, this new template is still in the proposed stage, and Medicare is accepting comments. You do not have to use this new […]

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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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Scheduling Solutions for Clinician Work-Life Balance

One of the most challenging conversations in any multi-physician practice or specialty-based hospital employed group is about how to create a fair distribution of on-call and/or inpatient hospital service coverage while balancing the duties of an outpatient practice. The COVID-19 pandemic has contributed to clinician burnout, and physicians and Advanced Practice Providers (APPs) place significant […]

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Tips for Ambulatory and Service Line Optimization

“There may be no faster death of a great idea or business than a dysfunctional team”, said Daniel Newman from Principal Analyst of Futurum Research and the CEO of Broadsuite Media Group. Over the last 15 years, hospitals have acquired or employed clinicians and other ambulatory services. Unfortunately, not all employment arrangements are part of […]

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How to Drive Growth in Elective Surgical Practices

Elective surgical practices have suffered significantly since the beginning of the COVID-19 pandemic. Patients seeking elective surgical treatment had their procedures postponed or canceled as hospital systems were striving to preserve bed capacity in anticipation of or in response to a spike in COVID-19 related admissions. Private practices and hospital systems alike lost incredible amounts […]

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2022 Physician Fee Schedule Final Rule: Highlights

Do you know that CMS is making significant changes to split/share and critical care services in 2022? Are your providers aware of the changes? Are they prepared to modify the documentation of these services? Are your coders prepared to report the required modifier? On November 2, 2021, CMS released the 2022 Physician Fee Schedule Final […]

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Blue & Co., LLC acquires Alerding CPA Group

Blue & Co., LLC acquires Alerding CPA Group

Carmel, Ind. (November 23, 2022) – The accounting and consulting firms of Alerding CPA Group (Indianapolis, Ind.) and Blue & Co., LLC (Carmel, Ind.) have announced their merger. The combined firm will operate as Blue & Co., LLC (Blue & Co.), effective December 1, 2022. This acquisition will provide Blue & Co. with greater market […]

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Not-for-Profit Single Audit Requirements – Evaluation of Revenue Sources

By: Holly Fields, CPA, Senior Manager Not-for-profit organizations (NFPs) that receive federal financial assistance over certain levels, either directly from a federal agency or indirectly through state or local agencies, may be required to have a single audit performed under Federal Uniform Guidance. Single Audit Requirements A single audit includes not only an audit of […]

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Occupational Mix Survey: What You Need to Know

Every three years, the Centers for Medicare and Medicaid Services (CMS) requires any Hospital that is subject to the Inpatient Prospective Payment System (IPPS) to complete an Occupational Mix Survey (OMS). This data is then used to calculate an Occupational Mix Adjustment Factor (OMAF). The occupational mix adjustment impacts a hospital’s average hourly wage and […]

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