Industry Groups Fuming about OPPS Proposed Rule Cuts of 340B Payments

by Phil C. Solomon August 2, 2017

The Centers for Medicare & Medicaid Services (CMS) is pursuing changes that would cut 340B payment rates to hospitals and may impair safety-net hospitals’ ability to treat low-income patients. The 340B program requires drug manufacturers to provide outpatient drugs to eligible healthcare organizations and covered entities at considerably reduced prices.  The long-standing Medicare policy allows […]

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2:00 PM Today – Webinar: The Ins and Outs of HCC Coding for Better Reimbursement

by Phil C. Solomon July 31, 2017

Webinar: The Ins and Outs of HCC Coding for Better Reimbursement August 10, 2017 | 2:00 to 3:00 pm EDT Do you have risk-adjusted physician services contracts for your Medicare Advantage patients? Then read on…you may be leaving money on the table by missing proper codes and creating inaccurate HCC coding. Don’t miss this opportunity to […]

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25 Keys to a Patient-Centric Revenue Cycle

by Phil C. Solomon July 19, 2017

Optimizing your revenue cycle management process is a key component for addressing a multitude of industry trends such as changes in regulations, consumerism and new reimbursement structures. Today’s patient centric revenue cycle requires the right systems to drive performance; however, employing systems based solely on their robustness does not guarantee success.  Optimal financial performance is […]

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CMS Actuary and CBO Differ on Predictions for Costs and Uninsured for the AHCA

by Phil C. Solomon June 28, 2017

The Centers for Medicare and Medicaid Services has estimated that the House-passed American Health Care Act (AHCA) would reduce insurance coverage by 13 million people by 2026—10 million less than the Congressional Budget Office’s (CBO’s) prediction. The actuary estimated that average net premiums paid by consumers in the individual insurance market in 2026 would be […]

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Announcing: HCC Reimbursement Strategies Webinar June 22, 2017, 2-3 pm EDT

by Phil C. Solomon June 15, 2017

Announcing New Webinar: HCC Reimbursement Strategies Do you have risk-adjusted physician services contracts for your Medicare Advantage patient? Then read on…you may be leaving money on the table by missing proper and inaccurate HCC coding. Don’t miss this opportunity to learn about risk adjusted HCCs and the strategies that will keep you in compliance and […]

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The Key Roles Medical Billers and Coders Play in Health Care

by Phil C. Solomon June 12, 2017

Medical billers and coders typically don’t make headlines but they are imperative to the success of any medical facility. Carrington College has submitted the following infographic which describes how the coding process translates from an encounter to billing of a claim. Translating Care into ICD-10 Codes There are over 140,000 codes used to denote different types of examinations, […]

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New Webinar: Improve HCC Reimbursement with Risk Adjustment Coding Strategies

by Phil C. Solomon June 6, 2017

Join us for our upcoming free webinar: Improve HCC Reimbursement with Risk Adjustment Coding Strategies June 22, 2017 | 2 pm – 3 pm EDT Register Now: Improve Reimbursement with Risk Adjustment HCC Coding Strategies https://attendee.gotowebinar.com/register/4600147017512814083?source=sm-1 Medicare Advantage makes up 31 percent of total Medicare spending, serves over 17 million enrollees and it is expected […]

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Providers Leaving Money on the Table – Proper HCC Coding Eliminates It

by Phil C. Solomon May 26, 2017

The Centers for Medicare and Medicaid Service’s (CMS) Hierarchical Condition Category (HCC) risk adjustment model calculates risk scores, which will adjust capitated payments made for aged and disabled beneficiaries enrolled in Medicare Advantage (MA) and other plans. The CMS-HCC model design uses two risk segments with separate coefficients to reflect the cost patterns of beneficiaries.  The […]

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Administrative Burden of EHRs Opens Doors to Medical Scribes

by Phil C. Solomon May 17, 2017

A physician’s responsibility is to provide the best possible care for sick patients.  A key for delivering quality healthcare is open communication between the physician and patient to discuss issues and develop a care plan.  Today, providing quality care is becoming more difficult due to increasing patient loads and administrative challenges.  This dilemma has become […]

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The Business of Healthcare Overview That You Don’t Want to Miss

by Phil C. Solomon April 27, 2017

Interesting Facts About The Business of Healthcare If you have a question about the hospitals and the healthcare industry, you will probably find the answer here.  This article will give you some interesting facts about the industry in 2017. Healthcare makes up a large part of the Gross Domestic Product (GDP) in the US.  It […]

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American Health Care Act Update Review

by Phil C. Solomon March 21, 2017

The House proposal to “repeal and replace” the Affordable Care Act (ACA), the landmark and controversial legislation that is a signature of President Barack Obama’s administration, indicates that the nation’s healthcare system could be heading for yet another upheaval.  March 21, 2017 marked the seventh anniversary of the ACA.  Although there is still a high […]

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Consumers, Employers and Providers Take the Hit from Rising Healthcare Spending

by Phil C. Solomon March 17, 2017

Since the adoption of the Affordable Care Act (ACA) and the subsequent rules changes that have taken effect, comprehending the changes to the healthcare industry has become a difficult task for anyone, let alone consumers.  Keeping up with the transformation is difficult, even for industry insiders.  Recent news reports demonstrate this: ·       Aetna is pulling […]

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