Industry News

Stay on top of the business of healthcare. Check this page often for published articles, trends and revenue cycle research studies.

8 most common medical coding errors

By Becker's Hospital CFO Report | August 15, 2018

Government and private health insurer audits have recently revealed several fraudulent or abusive medical billing practices, Kevin B. O’Reilly, editor of AMA Wire, said. Providers need to ensure proper billing practices not only to avoid fraud, but to maintain a profitable business.

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Exploring the Fundamentals of Medical Billing and Coding

By RevCycle Intelligence | August 6, 2018

Medical billing and coding translate a patient encounter into the languages used for claims submission and reimbursement. Billing and coding are separate processes, but both are crucial to receiving payment for healthcare services.

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How Hospital Merger and Acquisition Activity is Changing Healthcare

By RevCycle Intelligence | July 23, 2018

As value-based reimbursement puts financial pressure on providers, healthcare organizations are striving for efficiency, cost control, and sustainability. An increasingly popular strategy to fulfill all these goals is to engage in hospital merger and acquisition (M&A) activity.

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How to Maximize Revenue with Improved Claims Denials Management

By RevCycle Intelligence | July 21, 2018

Claims denials may be a part of life for healthcare revenue cycle managers, but a prevention-focused denials management strategy may be able to significantly reduce the number of times billing staff are faced with unpaid claims.

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CMS Proposes 2019 Physician Payment, Quality Payment Program Changes

By RevCycle Intelligence | July 18, 2018

CMS recently proposed major changes to Medicare physician payments and the Quality Payment Program to reduce the administrative burden of medical billing.

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Overcoming the Top Challenges of Claims Denial Management Audits

By RevCycle Intelligence | July 17, 2018

Increasing efficiency and improving revenue are top priorities for health care providers with a big focus on improving prior authorizations and eligibility before an episode of care. However, leveraging data and consulting expertise to improve denials management can be something that most providers often overlook.

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Key Terms, Components of Payer Contracts Providers Should Know

By RevCycle Intelligence | July 16, 2018

Providers are in the business of keeping their patients healthy. But confusing payer contracts riddled with “legalese” and other complicated provisions can get in the way of improving patient outcomes.

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What Is Healthcare Revenue Cycle Management?

By RevCycle Intelligence | July 9, 2018

While hospitals, small practices, and larger healthcare systems are known for saving lives and treating patients, every healthcare organization needs to develop successful processes and policies for staying financially healthy. That is where healthcare revenue cycle management comes in.

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How to Maximize Revenue with Improved Claims Denials Management

By RevCycle Intelligence | July 9, 2018

Claims denials may be a part of life for healthcare revenue cycle managers, but a prevention-focused denials management strategy may be able to significantly reduce the number of times billing staff are faced with unpaid claims.

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What Are the Benefits of Clinical Documentation Improvement (CDI)?

By EHR Intelligence | July 2, 2018

As healthcare organizations continue to utilize data that is becoming increasingly complex, it is essential that the data is captured and documented properly. Clinical documentation improvement (CDI) helps ensure that the events of the patient encounter are captured accurately and the electronic health record properly reflects the services that were provided.

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WHO releases ICD-11: 5 things to know

By Becker's Hospital CFO Report | June 25, 2018

After more than a decade in the making, the 11th edition of the International Classification of Diseases has been released by the World Health Organization. The ICD serves as a foundation for identifying global health trends and statistics and is used by health insurers whose reimbursements depend on ICD coding.

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What’s the Diagnosis for ICD-10-CM?

By Jennifer Bishop - VitalWare | June 19, 2018

The ICD-10-CM diagnosis code additions, deletions and revisions for FY 2019 have been released! These code changes will be effective October 1, 2018.

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ICD-10 Allows Non-Physician Documentation of Social Determinants

By Health IT Analytics | June 18, 2018

Recent guidance around ICD-10 states that non-physician documentation is an appropriate source for coding the social determinants of health. Healthcare organizations concerned about how to record data on patients’ social determinants of health are allowed to use non-physician documentation to support ICD-10 coding for common socioeconomic issues, says the American Hospital Association (AHA).

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The 2019 diagnosis code changes are here: 6 things to know

By Becker's ASC Review | June 13, 2018

The CDC published the ICD-10-CM code changes June 11 for fiscal year 2019. Here’s what you should know:

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Hospitals Wait 16 More Days for Late Payments from Claim Denials

By RevCycle Intelligence | June 12, 2018

Delayed payments stemming from claim denials are significantly impacting hospital revenue cycles, taking an average 16.4 more days to pay compared to claims that have not been denied, a new analysis from Crowe Horwath revealed.

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