The National Committee for Quality Assurance (NCQA) will be releasing new updates on 7/1/2020. Historically, health plans reporting HEDIS data receive guidelines 6-7 months after the start of data collection, unfortunately, half of the reporting year is over before the plans ultimately know what information needs to collected.
The American Association for Professional Coders has a conglomeration of more than 500 Local chapters spread all across USA. Governed by the AAPC chapter association, the members, by and large, belong to a Local chapter who enjoy facilities like obtaining continued online education units, conducting examinations, establish a close connect with the peers in the industry as well as promoting healthcare industry in the local horizon.
A recent research report by MarketsandMarkets, the global market research platform, predicted that North America would account for “the largest share of the healthcare claims management market in 2018”. The report goes on to state that, “the payers segment is expected to command the largest share of the market in 2018”.
Did you know that faulty RCM processes result in losses of millions of dollars in revenue for hospitals and clinics in the US every year? Of course, the other side of the coin is that an RCM process that is streamlined could potentially increase revenue that much more! In an increasingly competitive healthcare environment, with even stricter regulatory and compliance checks in place, a meticulous and error-free RCM process is an asset for any organization, no matter what it’s size or specialization.
Healthcare organizations require a high degree of accuracy in medical coding in order to keep their revenue cycle management systems running smoothly. From ensuring compliance with state and federal regulations, to making sure that reimbursements are paid on time and to the maximum, medical coding is the backbone of every healthcare organization’s financial health, whether it's a small physician group or a large hospital.
Whether you're part of a physician group, a small clinic, or a large hospital, are you sure that coding audits are being conducted regularly? Did you know that coding audits that are conducted monthly can save your practice/clinic/hospital a great amount of money, not to mention time as well?
For a healthcare provider or an RCM stakeholder, the importance of clinical documentation improvement (CDI) cannot be emphasized enough. The different healthcare reforms that have been introduced have only served to highlight how critical it is to ensure the maximum accuracy for all documents at all times.
Medical coding professionals are crucial to the smooth functioning of the healthcare industry. Through accurate coding, healthcare providers get accurate reimbursements which keep revenues flowing smoothly, while healthcare recipients pay only what is fair and required. So it can be said that medical coding professionals keep everyone on both sides of the healthcare spectrum happy!
ACOs (Accountable Care Organizations) work in sync with the Affordable Care Act (colloquially called Obamacare) to redefine the landscape of healthcare in the United States. ACOs aim to reduce healthcare costs for the provider (physician practices/hospitals) and the payer (insurance firms) while also benefiting patients.
Medical coding is an integral part of healthcare administration. Trained medical coders extract information from the documentation created by a healthcare provider. ICD-9-CM has been around since 1979 with a few revisions done to it through the years. However, there will be a drastic change in this scenario as ICD-10-CM and ICD-10-PCS is all set to be implemented shortly. This sure does change the face of the medical coding industry while generating an acute need for outsourcing.