Insurance Billing Rules

Quick Tip – What is the Birthday Rule?

How do you determine whose insurance is primary and whose is secondary when parent both have insurance coverage? The answer to that question is known as “The Birthday Rule”. The Birthday Rule The birthday rule states:  The primary payer is determined by the parent whose birthday falls first within the calendar year. If both parents…

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Don’t Make These Two Classic Managment Mistakes

Unbridled IT projects and lack of communication have been the cause of much waste in healthcare.  Just this last week I encountered a client that had major cost overruns because of unclear communication with their IT department.  This group had simply given IT a general directive on a sizable project and simply left them to…

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Black Book Rankings

Black Book Award Winners Showcase Revenue Cycle Cycle & Coding Solutions at 86th AHIMA

The number of outsourced coding and revenue cycle management initiatives have doubled over a years’ time as the number of hospitals confront the challenges of implementing suitable solutions before the 2015 ICD-10 deadline, according to the recently published Black Book™ surveys of hospital technology and physician leaders. This week many of those leaders will gather…

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ICD10

A Primer on How ICD10 Impacts Revenue Cycle

Procedure billing has been much more effective since the introduction of the Current Procedural Terminology (CPT) coding system.  The CPT system was created by the American Medical Association (AMA) and intended to standardize and facilitate medical billing.  CPT consists of a collection of alpha-numerical codes which describe the services and treatments medical groups perform.  They…

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Stay Focused

Stay Focused

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Practice for sale and the fight to remain independent

Practice for sale and the fight to remain independent By James Muir, Vice President Revenue Cycle Management, Sales Trends show that physicians who own private practices are looking for a way out. Fed up with their rising business expenses and shrinking payouts from insurers, many are selling their practices to hospitals. Experts report the number…

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Zirmed

ZirMed Acquires MethodCare to Broaden its SaaS Platform and Enterprise Reach

ZirMed Acquires MethodCare to Broaden its SaaS Platform and Enterprise Reach ZirMed®, the premier cloud-based enterprise business and clinical performance solution for healthcare, today announced the acquisition of MethodCare, Inc. Chicago-based MethodCare is a leading provider of predictive analytics solutions that increase revenue, maximize operational efficiencies, and provide the advanced analytics to help healthcare organizations…

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Challenge Yourself

Challenge Yourself

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CMS Puts Away the Carrot and Brandishes the Stick: How to Plan in 2015 to Protect Your 2017 Income from CMS Penalties

CMS Penalties Begin to Pile Up

The cumulative penalties from Meaningful Use, PQRS and Value-based Modifier (VBPM) are piling up.  There was a time when we thought of Meaningful Use and PQRS as revenue enhancing programs.  Incentives that we could opt in or out of at our leisure.  And Value based payment modifiers seem to have completely slipped under the radar…

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Outsourcing Claim Creation Infographic

Claims Outsourcing Infographic

Thanks to John Lynn for posting this infographic on outsourcing claims. Click here to view original web page at www.emrandhipaa.com

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