Thought Leadership

When it comes to thought leadership and staying informed, we’ve got you covered. See below for recent articles, webinars, and downloadable resources available.

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Update from the AHIMA Advocacy Summit 2018

Update From The AHIMA Advocacy Summit 2018

The American Health Information Management Association (AHIMA) held its annual Advocacy Summit in Washington, DC on March 19-20, 2018. Members from all over the country came together to inspire leadership and influence change. Historically, this event has been an opportunity to advocate for HIM professional interests, build name recognition for AHIMA and the profession, and […]

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MIPS Reporting Deadlines Are Almost Here!

Don’t wait until the last minute to submit your data for the 2017 Merit-Based Incentive Payment System (MIPS) performance period. Now is the time to act. The key dates are: Passed: March 1, 2018, for your 2017 data for your performance category via claims March 16, 2018, (by 8PM EST), for group reporting via the […]

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Skilled Nursing And Post-Acute Providers Have A Proposed New Payment System

The newly proposed Department of Health and Human Services (HHS) budget was recently announced for skilled and post-acute nursing providers. According to major trade groups, the changes for skilled nursing providers are not seen as positive. Payments for post-acute care providers would be changed, establishing a unified payment system based on the needs of patients, […]

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CMS Posts Draft Version Of The MDS 3.0 Data Specifications For Oct. 1, 2018

The Centers for Medicare and Medicaid Services posted a new version of the Minimum Data Set (MDS) 3.0 Data Specifications on January 25, 2018. The DRAFT version proposes significant changes to the MDS Sections: GG – Functional Abilities and Goals; I – Active Diagnosis; J – Health Conditions; and M – Skin Conditions Blue & […]

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The Future Today: Telehealth

The Future Today: Telehealth

Telehealth and its emergence as a critical healthcare component is becoming painfully evident. Patient demand is rising and according to Zion Market Research, an estimated $38 billion will have been invested by the year 2022 by companies such as Google, IBM, Samsung, and many more. Right now, the only billable facility charge is the originating […]

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2018 Evaluations Management Proposed Changes

Update On The 2018 Evaluation And Management Proposed Rule Change

Most physicians/practitioners bill patient visits to payers using a set of codes known as evaluation and management (E/M) codes. Billing physicians/practitioners must maintain certain information in the medical record that documents the appropriate E/M codes have been reported. The 2018 Final Rule for Revisions to Payment Policies under the Physician Fee Schedule has been published. […]

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Is your charitable hospital in compliance with IRC 501(r)?

Is Your Charitable Hospital In Compliance With Irc §501(r)?

Even though there have been several attempts this year to repeal the Patient Protection and Affordable Care Act (the “ACA”), the efforts have not been successful. Additionally, the attempted repeal and replace approaches this year have left most of the ACA intact; meaning even if the bills were passed, those requirements initially enacted in Section […]

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The Future Of Coding Clinical Validation Reported Diagnoses

Lynette Thom, BS, RHIT, CCS, CDIP AHIMA Approved ICD-10-CM/PCS Trainer U.S. hospital revenue cycles have been undergoing radical changes since the advent of the prospective payment system (PPS). In response to this radical change to the way they earned revenue, hospitals fought for changes to the PPS to prove to Centers for Medicare and Medicaid […]

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New service: Supervised exercise therapy for symptomatic peripheral artery disease

Supervised Exercise Therapy (SET) For Symptomatic Peripheral Artery Disease (PAD)

On May 17, 2017, the Centers for Medicare & Medicaid Services (CMS) determined that the evidence was sufficient to cover supervised exercise therapy (SET) for beneficiaries with intermittent claudication (IC) for the treatment of symptomatic peripheral artery disease (PAD). Up to 36 sessions over a 12-week period are covered if all of the following components of […]

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Charity Reimbursement

Charity Reimbursement: Protecting it from Audit Scrutiny

There is a new audit trend coming down the pipeline that could impact your charity reimbursement for Medicare bad debt. In the past there was no enforcement of statements being sent to a charity patient before they were deemed indigent. Until a patient has been approved for charity, they are still deemed non-indigent. Auditors are […]

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HIPAA and Covered Entities

Anyone who works in the healthcare industry knows that their organization takes steps to protect patient health information under a series of guidelines known as HIPAA. There are several provisions to HIPAA that require organizations to use Federal guidelines to ensure digital health information is secure. Those provisions include: Privacy Rule Security Rule Enforcement Rule […]

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Rural Health Clinic Payment

Rural Health Clinic Payment Reform

On December 27, 2020 the Consolidated Appropriations Act of 2021 introduced changes to the existing Rural Health Clinic payment structure. Changes to the Rural Health Clinic Payment Structure This legislation introduced the following reforms: Phase-in steady increases in the RHC statutory cap over an eight year period Subjects all new RHCs to the new Medicare […]

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Revenue Improvement

Revenue Improvement Case Study: Outpatient Physical and Occupational Therapy

Blue & Co. reviewed publicly available information on a 120 bed, non-profit, acute-care hospital. The data suggested there was revenue improvement opportunity in their outpatient physical and occupational therapy departments. The department had approximately 27,000 patient visits the previous year. During an assessment, we co-validated a significant set of revenue improvement opportunities: charge capture improvement, […]

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Patient Experience Competencies

Patient Experience Competencies to Drive Your Consumerism Strategy

The concept of consumerism in healthcare delivery is rooted and shaped in the world of retail services. To keep it simple, patient experience competencies should drive your consumerism strategy. However, it is primarily driven by high deductible health plans, changing technology, shifting patient demographics and value-based care payer contracts, healthcare care consumerism and the experience […]

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Annual Wellness Visit

Annual Wellness Visit: Your Organization Should Care

Beginning 2011, Medicare began covering the Annual Wellness Visit (AWV) as a yearly appointment with a primary care provider (PCP) to create or update a personalized prevention plan at no cost to the beneficiary. This plan may help prevent illness based on current health and risk factors. It is not a routine physical, and an […]

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