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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ICD-10 Impacts Insurance Verification for Payors and Providers if Codes are Included in Workflow

ICD-10 transition has several impacts that many health plans and health care providers will not consider, unless they are doing a comprehensive assessment of all systems and processes. If ICD-9 diagnosis coding (ICD-9 CM) and ICD-9 procedure codes are included in the workflow.

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ICD-10 and Oncology – How ICD-10 CM Impacts Cancer Registries – Commission on Cancer Participants

If you are in a CoC hospital registry, you are also collecting complications and co morbidities, which are ICD-9-CM codes. These codes will be replaced by ICD-10-CM.

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ICD-10 Crosswalk using ICD-10 Predictive Analytics

Now that some health plans and health care providers have completed their ICD-10 Assessments many are trying to determine what to remediate and how to selectively prioritize clinical documentation improvement for health care providers. Health plans are prioritizing their remediations and should be looking at their claims mix and contracted providers as well as test plans. An ICD-10 Risk Assessment using ICD-9 and ICD-10 predictive analytics can help.

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5 Experts at San Diego Healthcare Innovation Summit April 17th at Scripps La Jolla

Experts to Review Electronic Health Care Innovation, Regulations and Mobile Health at Scripps, April 17th A group of companies will participate in a comprehensive discussion on the current and future…

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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 Implementation Consulting Best Practices

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.

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Buffett Divests of Muni Bonds. What is Hospital Link?

What WSJ missed in their video recap: 15% of many muni-portfolios are NOT municipality related bonds. They are hospital revenue bonds. Buffet is the leader; average investors will now scrutinize this point and perhaps review what this means in hospital bonds and what reimbursement risks such as ICD-10 may be driving risk in the future.

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Out of Network Claims Cost Containment Strategy : Don’t Damage MLR

Since most of the cost containment and settlement solutions vendors do charge the plan, this actually works against the health plan's ability to manage their expenses and comply with regulations. Health plans should look to solutions that support the MLR calculation and regulations, and maximize the speed and the amount of reimbursement to the provider.

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ICD-10 Delay – How Disruptive Regulations and Risk Can Provide Immediate Financial Benefit

We believe we can save health plans and self-funded employers 15% or more, and accelerate claims payments to providers from 90 days to 7 days. If you can do that, you can get the CFO of the healthcare organization to consider investing in the future, which includes all of the regulatory compliance work for ICD-10 and related initiatives.

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Why did the AMA vote to try to skip ICD-10 and move to ICD-11?

Delaying ICD-10, AMA believes will help preserve its relevance, and its control over physician compensation. Sadly it seems that AMA hasn't served its own members well, or the healthcare industry. ICD-11 won't "arrive" in a year or two. Our health system needs to digest it and then determine when and how to move to it. While ICD-11 has some intriguing benefits, it is a long way off. The base version from WHO is expected in May 2015. After that, the United States will probably need another two years for development of the US version. The earliest it would be available for study would be 2017, and we would need another 4 years to implement it – so that brings us out to 2021, way too far in the future.

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