ICD-10 for Orthopedics – Fracture Concepts, Specificity, Laterality and Documentation

ICD-10 for Orthopaedics ICD-10 for orthopedics includes the most number of codes, however, orthopedics concepts such as laterality (left, right) type of fracture, the severity of the fracture, issues such…

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ICD-10 Consulting Must Be More than IT and Training – Clinical Documentation, Physician Engagement Key

ICD-10 consulting - clinical documentation should start with analytics that look retrospectively at ICD-9 CM and ICD-9 procedure codes to see how DRGs, documentation of medical necessity are working today.

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Get Ready for Obamacare

On October 1, 2013 Health Insurance Exchanges (aka Insurance Marketplaces or HIX) will start operating. Here is an overview of some of the things consumer can expect. Click the "play" icon to view a presentation from Kaiser Family Foundation. "Obamacare" is short for the Patient Protection and Affordable Care Act. Our firm specializes in Obamacare HIX and Accountable Care Organization (ACO) Strategies, and healthcare economics related to disruptive standards such as ICD-10, Meaningful Use of Electronic Health Records, and CORE Operating Rules.

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ICD-10 Financial Impact Assessment

ICD-10 Financial Impact Assessments should include an understanding of: ICD-10 Financial Impact to Revenue Cycle Management ICD-10 Financial Impact based on DRG shifts ICD-10 Financial Impact based on ICD-9 to ICD-10 mapping risk ICD-10 Financial Impact based on use of unspecified codes Health Information Technology (HIT) Impacts: ICD-10 Financial Impact to the Health Information Management (HIM) department ICD-10 Financial Impact to IT as distinct from the clinical applications such as resource conflicts ICD-10 Financial Impacts to training budgets, which should include the Human Resources Department ICD-10 Financial Risk and Impacts to denial management with respect to payer relations and contracting

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Will Healthcare Go the Way of Farming in the U.S.?

a focus on income support has remained constant. We can assume that based on recent U.S. policy certain incentives and regulations will continue in healthcare and that the general effect will be to encourage scale and specialization. The main difference between healthcare and agriculture is that interoperability is essential for the former and will create cooperatives focused on data sharing just as in agriculture smaller providers have historically joined forces to achieve economies of scale and reduce redundant processes.

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September 11th Anniversary – Triumph of American Spirit Sets Tone for Future and Upcoming National Health IT Week

The 9/11 Anniversary this year appears to be dominated by hope for the future.  In this remarkable time lapse photography you can see what America can do when it puts…

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Figliozzi and Company Meaningful Use Audits – CMS Designee Can Take Back Incentive Funds

Despite recent writings by some law firms, a failed Meaningful Use audit ("final determination") is a serious affair, requiring the attesting organization to immediately pay 100% of the Meaningful Use incentive funds back to CMS. For a $500 million hospital system, for example, this is likely to be $millions.

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ICD-10, Case Management, Revenue Cycle Management, RAC Audits, and Dual Eligbles

Case Management should benefit the entire system, bridging clinical and financial ares of healthcare. Underlying Case Management processes are a number of functions. Case Management also relies on specific diagnosis codes. If hard-coded information or ICD-9 specific methods of capturing this information are in Case Management Systems, they will need to be remediated or replaced to support ICD-10.

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