U.S. Led in Contributions but Failed to Receive Commensurate Benefits In the two-year period ending at the close of 2019, the U.S. contributed $893 million to the World Health Organization,…
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Forbes published an article on December 11, 2019, after interviewing the Administrator of the Centers for Medicare and Medicaid Services (CMS), Seema Verma. Ms. Verma itemized three focus areas: the lack…
Medical billing expert witness Howell specials work in California in matters involving personal injury, medical malpractice, and payor provider disputes. Experts should have an understanding of the collateral source rule.…
MACRA Changes Health Care Economics with a Focus on ChildrenMACRA Background: A final rule released on Oct. 14, 2016 by the Centers for Medicare and Medicaid Services (CMS) details the final…
ICD-10 Implementation, Consulting, and Conversion programs have changed since the first projects started in 2009. For providers, in 2013 and 2014 we forecast more ICD-10 implementation consulting programs focused on first…
ICD-10 codes have expanded significantly for the cardiology and vascular surgery specialties. However, many of the concepts such as laterality (left, right) are spread across the human circulatory system. Therefore,…
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.
In healthcare, the federal Patient Protection and Affordable Care Act (PPACA) introduces a new income definition—Modified Adjusted Gross Income (“MAGI”) for determining Medicaid income eligibility across the country. MAGI, pronounced the same way as the Biblical term, will be a regular figure in future accounts of who has access to the best prices for health care coverage and will be relevant for Insurance Exchanges ("HIX").
One strategy is to continue to move ahead on ICD-10 process impacts, systems planning, and overall budgets but depending on readiness, get your consulting firm to help with both the requirements documentation and strategies for clinical documentation that don’t’ exist now. Why? The WEDI / NCHICA timeline suggests that health care providers should have started planning for ICD-10 about 18 months before the CMS announcement of a delay.
August 28, 2012 Angela Braly, the CEO of WellPoint is stepping down.
In the ICD-10 Consortium social network this week, health plans posted questions regarding processing ICD-10 claims that have date of service periods that span the mandated timeline as well as an outreach to other health plans regarding the pros and cons of receiving an ICD-10 claim, mapping it to an ICD-9 to adjudicate it. Also, ICD-10 is expected to impact auto adjudication rates for plans.