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4 Healthcare Trends Set into Motion by the ACA

November 18, 2015 by Moira O'Connell

2015 marks the Affordable Care Act's 5th anniversary. Five years later, the ACA has sparked change in the healthcare ecosystem and is continuing to churn the wheel of change. But what changes should healthcare organizations expect for the future?[read more]

5 Key Elements of the Peer Review Process

November 13, 2015 by Moira O'Connell

Lately we have been talking about the importance of Independent Review Organizations (IROs) and peer reviews in the healthcare ecosystem. Today we continue this discussion and delve deep into the importance of the peer review process. So let’s take a look at the 5 core building blocks of the peer review process.[read more]

CMS Announces Meaningful Use Final Rules & Stage 3 Implementation

October 22, 2015 by Moira O'Connell

Now that the ICD-10 panic has subsided the healthcare world is focusing on something new: Meaningful Use. Despite mixed reactions from the public and congress, many of whom expressed concern about the proposed changes and rules,[read more]

Investor red flags- always logical?

October 20, 2015 by Ruchi Dass

A few of my interns recently did a brain-storming session with me. They were all enthusiastic to do something of their own and had many questions. Many of them I met at several accelerator competitions and hackathons. I am not an authority or a VC. So far, I have invested in 9 companies globally- all in healthcare or education. One thing...[read more]

From Lake Placid: Doc Generously Donates Surgeries, Resources

October 20, 2015 by Annette Hogan

While on a boat tour of Lake Placid over Labor Day weekend, I listened as the tour guide talked about Camp Carolina, the historic lakeside home of one long-time resident, Dr. Howard Smith. The guide went on to describe Dr. Smith’s many trips around the world organizing and donating surgeries for people born with cleft lips and palates....[read more]

Medicare Rates Set to Soar

October 15, 2015 by Phil C. Solomon

 The Fed is talking about raising interest rates and now Congress so far has failed to find a way to stave off an unprecedented premium increase for millions of recipients in 2016.Is our economy ready to take this one two punch? What say you? C....[read more]

Eliminating Risk with Independent Review Organizations & External Reviews

October 14, 2015 by Moira O'Connell

We’ve been talking a lot lately about how and where Independent Review Organizations, or IROs, fit into denial management. The Peer Review process, which brings in an unbiased third party to help alleviate the pressure of reviewing claims, is an essential part of denial management. We’ve touched on many of the different benefits of IROs in previous blog posts, from how they affect your ROI to how they bring specialized expertise to reviews. This blog post focuses on the four main ways IROs and external reviews can help eliminate risk within your organization.[read more]

Why do sick people quit their Medicare Advantage plans?

October 12, 2015 by David E Williams

Heading back to Mama FedHealth plans don’t like sick people. They rack up big medical expenses, drive up health plan administrative expenses, and generally knock down profitability. In the bad old days of Medicare managed care, some plans went out of their way to make sure their membership rolls were filled with healthy people. My...[read more]

When Patients Don't Pay the Bill: Increase Your Revenue with a Collection's Strategy

October 12, 2015 by Annette Hogan

In addition to caring for your patients and clients, a normal day in your healthcare business includes collecting copays, coding claims, billing patients, processing incoming payments and, unfortunately, asking some patients to pay a bill that is overdue.We asked the CEO of Capital Collections Management, Jacob Corlyon, about the...[read more]

Poll Finds Overwhelming Support For Medicare Paying For End-Of-Life Talks

October 2, 2015 by Liz Seegert

via Kaiser Health News The public overwhelmingly supports Medicare’s plan to pay for end-of-life discussions between doctors and patients, despite GOP objections that such chats would lead to rationed care for the elderly and ill, a poll released Wednesday finds. Eight of 10 people surveyed by the Kaiser Family Foundation supported the...[read more]

ICD-10: The Countdown is Over – Last Minute Tips

October 1, 2015 by Moira O'Connell

October 1st is here and with it arrives ICD-10. Whether the looming implementation date of the new codes sent your organization into a state of urgency or the date felt like a non-event, ICD-10 is here. There will be a strong focus on the transition to ICD-10 in the coming months and we know it isn’t going to be easy, as resources and employees get allocated to fix errors and educate staff.[read more]

Top 80 Wackiest ICD-10 Codes

September 30, 2015 by Phil C. Solomon

 The U.S. healthcare system needs an overhaul. I don’t know of anyone who would disagree with me. Beginning tomorrow, October 1st health providers will transition to a new clinical documentation system called ICD-10 (International Classification of Diseases) to document a provider’s encounter with a patient. The previous system, ICD...[read more]