CMS Moves forward with CPC+ that Includes PMPM to PCPs

According to CMS, the Original Comprehensive Primary Care (Original CPC) Model, is being replaced with the Comprehensive Primary Care Plus (CPC+) which is intended to allow health care provider practices to apply for one of two program tracks, with increasing payment and care redesign expectations from Tracks 1 to 2.

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Healthcare Expert witness, HIPAA, HITECH Act, Medical Coding and Affordable Care Act Considerations

healthcare expert witness work in medical coding and billing, usual customary and reasonable cost of care, HIPAA Privacy, HITECH Act, and Affordable Care act require special considerations

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CMS and OIG Meaningful Use Audits Increase, HIPAA Breaches factor in. What’s your Strategy?

If your hospital is notified by CMS that is auditing your organization's ┬áMeaningful Use (MU) attestation you will need a clear action plan and the advice of experienced people who…

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Three EHR Vendors Meet Meaningful Use 2014 Standard, Creates Challenge for EPs Wishing to Achieve Stage 2

By June 13, 2013 only three vendors are ready for inpatient, and three for ambulatory on the CMS website that shows which EHR vendors have their product certified for Meaningful Use under the 2014 Standard. This creates an issue for all Eligible Providers (EPs) who achieved meaningful use Stage 1. Unless their EHR vendor meets the Stage 2 requirements, those EPs no longer qualify for Meaningful Use stimulus dollars.

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Out of Network Claims Market Gets More Interesting: Cedars-Sinai, UCLA Dropped by Anthem

Out of Network Claims Explained One of the most significant inefficiencies in health care is the pricing strategy of health plans regarding their policy on reimbursement for members who receive…

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ICD-10 – Let’s Get On With It

We do not support a delay in ICD-10. The delay hurts not only those who have invested dutifully to meet the CMS mandate on time, but it hurts independent contractors, small businesses, and Healthcare IT vendors who fill knowledge gap in Covered Entities who don't have the staff internally to meet this mandate.

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PPACA Supreme Court Hearings Coverage in Social Media Need Holistic View

If The Patient Protection and Affordable Care Act (PPACA) is repealed it will be interesting to see if it is repealed in whole or in part. The Supreme Court of the United States (SCOTUS) may excise the individual mandate requiring health insurance coverage, or it could strike it down entirely.

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Stage 2 Meaningful Use, Interoperability of EMRs and ICD-10. What is CMS, ONC and HIPAA Impact on Accountable Care Organizations?

One of the key questions will be how the EMR provides a foundation with the Health Information Exchanges (HIEs) for comparative effectiveness data over the life span of a patient (sometimes called the continuum of care) and whether CDA standards currently proposed will accomplish that. Informatics people call this "longitudinal clinical data."

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ICD-10 and Bundling – Study Raises Questions About Bundling To Pay Doctors

ICD-10 will drive initiatives such as bundling, as a component of health care payment reform. Therefore reimbursement, and case management and other areas must be viewed in a broader landscape. HIPAA mandates and health care reform impact one another.

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ICD-10 Readiness Compromised by ICD-10 Revenue Cycle, Analytics Vendors

We find that most analytics and revenue cycle companies are ignoring the future role coordinated medical coding will have, the transition to ICD-10, and the clinical documentation and processes on the revenue cycle. The ICD-10 transition will re-write the book on revenue cycle management (RCM). RAC audits and Electronic Medical Records (EMRs) will be subject to a new paradigm with ICD-10.

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Concern persists for HIPAA 5010, ICD-10 non-compliance fines | Healthcare Finance News

Although no official word has been handed down regarding exactly what fines our federal government may slap against healthcare organizations that fail to comply with HIPAA 5010 or ICD-10, it…

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