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EHR News and Information: The HealthFusion Blog

The HealthFusion EHR news and blog brings you the latest in the healthcare industry and health IT news as it pertains to you and your practice.

Seth Flam, DO

Lead Blogger: Seth Flam, DO

Dr. Flam is one of the founders of HealthFusion and serves as the company's CEO and President. He is board certified in Family Practice and is one of the creative forces behind MediTouch EHR. More information about Dr. Flam can be found at www.SethFlam.com

Healthcare Claims Processing and its Impact on Healthcare Costs

Source: evidant.com
Between healthcare providers, hospitals, pharmacies, pharmaceutical companies and medical equipment manufacturers, the many moving parts of healthcare are meant to work together to ensure that patients are given priority. One of these moving parts deemed to play a major role in the success of healthcare, is healthcare claims processing. Steps in the Claims Process Processing Claims – The healthcare claims process starts when a patient visits a healthcare provider for a consultation, service, or treatment. Once the treatment is complete, a claim is filed. Submission of Claims – There are two ways […] Continue Reading

Tracking Medical Claims: Never a Lost Bill

clearinghouse-reporting
Most medical billing software platforms don’t have tools that assist the user in systematically reducing their AR. In addition, practices need a mechanism that looks at payment and compares it to the contracted fee schedule. Tracking the claim, working denials and your ambiguous AR is what separates superior billing software system from the rest. Continue Reading

Medicare ICD-10 Coding Flexibility – How It Works

ICD-10 coding
NOTE: Please read our three-part blog post on how to find success when this flexibility period ends in October of this year (2016). More specific coding will be required and many billing systems will fail, lacking the tools to support the more stringent coding requirements.  Early in July, at the urging of the AMA and other physician organizations, CMS agreed to offer flexibility with regard to ICD-10 coding during the first year of implementation: October 1, 2015 – September 30, 2016. In our July 6 blog post, we outlined the new rule – and a […] Continue Reading

AMA 12-Month ICD-10 Grace Period Accepted by CMS

ICD-10 coding
Implementation of the ICD-10 code set is just a few months away; the deadline is October 1, 2015. The AMA and other physician organizations have been campaigning for a grace period with regard to payment of claims that are not “perfectly coded” in ICD-10. Many physicians have been so concerned about adopting this code set they have been preparing for cash flow interruptions by obtaining lines of credit. The AMA and CMS were able to work on a set of grace period rules that will ease the transition to ICD-10 and reduce […] Continue Reading

AMA Endorses Latest ICD-10 Killer Legislation

ICD-10 coding
The AMA recently endorsed a new bill called “The Cutting Costly Codes Act of 2015”. The bill is the latest attempt to kill the scheduled October 1st, 2015 ICD-10 implementation. The endorsement came by way of a letter from AMA’s CEO, James Madara, MD, to Rep. Ted Poe (R-Texas), who sponsored the bill. Dr. Madara stated, “The timing of the ICD-10 transition could not be worse as many physicians are currently spending significant time and resources implementing electronic health records into their practices and adopting new payment and delivery models,” We believe […] Continue Reading

SGR Repeal Passed by Senate; No ICD-10 Delay Included

CMS SGR Repeal with No ICD-10 Delay
The Senate passed the Medicare Sustainable Growth Rate (SGR) repeal late Tuesday, leaving only a signature from President Obama to make it law. The President has indicated that he is eager to sign the bill, which is notable not only for what it includes but for what it does not include—namely, another delay of ICD-10. The new legislation not only eliminates the annual 21 percent Medicare payment cut that has hung over doctors’ heads since 1997, but also makes value-based reimbursement the new model for Medicare reimbursement. The SGR repeal includes a […] Continue Reading

CMS Clears Up Chronic Care Management Confusion Over Medicare Advantage and More, Part II

Chronic Care Management and Medicare Advantage
In our previous blog post, we discussed clarification provided by CMS on the Chronic Care Management coding program, which has generated many questions. You can read the first blog post now. Here is the second part of the summary of the Q&A session from the CMS MLN Connects call on February 18, 2015: Q: Regarding the requirement that we share the care plan information electronically with other providers; what happens if one of the providers cannot receive that information electronically? A: We talked to the Office of the National Coordinator for Health […] Continue Reading

CMS Clears Up Chronic Care Management Confusion Over Medicare Advantage and More, Part I

Chronic Care Management and Medicare Advantage
CMS clarified lingering questions about the new Chronic Care Management code under Medicare Advantage plans recently in a memo to Medicare Advantage organizations and on other topics in a February Q&A session at the end of an MLN Connects National Provider Call. In the memo regarding Medicare Advantage, Kathryn Coleman, director of the Medicare Drug & Health Plan Contract Administration Group, confirmed that the CCM was a covered Medicare Part B service “included in the basic benefit offered by every MA (Medicare Advantage) plan.” However, Coleman noted that Medicare Advantage organizations “have […] Continue Reading

April EHR Newsletter: Meaningful Use Stage 3, ICD-10 and More

Meaningful Use Stage 3 and more
Be sure to review the April issue of our free newsletter for up to date articles on the proposed rule for Meaningful Use Stage 3 and what it means to your practice, whether a delay of ICD-10 is likely, free webinars, and much more. If you don’t receive the newsletter via email, sign up for the monthly emails now. Free On Demand Webinar — Meaningful Use Stage 3: What the Future Holds Meaningful Use Stage 3 is just around the corner, proposed to begin October 1, 2017. Do you know what to […] Continue Reading

ICD-10 Deadline Delay Unlikely; SGR Fix Delayed But Likely

icd-10-featured
The ICD-10 deadline is set for October 1, 2015—but will it stick? The deadline has been pushed out twice before, of course, and industry experts are holding their collective breath waiting to see whether Congress will once again delay implementation of the new code set. The House overwhelmingly approved a fix for Medicare’s Sustainable Growth Rate (SGR) without any change to the ICD-10 deadline, which was a relief to those hoping to implement ICD-10 this year. But then the U.S. Senate adjourned for a two-week recess on March 27 without acting on […] Continue Reading