2014 INCREASED BURDEN PATIENT RESPONSIBILITY = down turn in provider revenue stream. 44% of employers stated they would only offer high deductible health plans. 87% of people enrolled through the Marketplace selected High Deductible Plans. 45% of people wait greater than 30 days to pay a medical provider. This is and will continue […]
Advantages: Small Business tax credit. Can’t be dropped from coverage. Individual tax credit subsidies. Young adults insured to age 26. All plans offer same set of essential health benefits. Disadvantages: Rates & Deductibles are going up 6%. Networks are smaller. Tax Credits are narrow. 9.5% rule increases to 9.56% (employee contribution in large employer setting).
Take Advantage of ERAs and EFTs Advantages ARE Less time spent on payment posting Fewer days on the books (Accounts Receivable) Decreased labor Expenses Removal of Lost EOB’s and or Checks Reduce risk of Theft of your checks Quicker Turnaround time to file on Secondary payors.
A Political Compromise: Led to a 1-year delay in ICD-10. A combination of volume growth and GDP slowdown have led to the Sustainable Growth Rate formula: Cuts to physician pay. Reminder, ICD-10 coding will capture a greater level of specificity for diagnostic information and offers the promise of greater insight from Data. The Delay affords […]
As you Know CMS assured organizations that the ICD-10 deadline would not change, Congress pushed the date back by at least one year to October 1, 2015. The reaction has left provider organizations wondering what to do next. Navicure is offering a Webinar to clarify “What to do Next” To learn what your organization should […]
GEMs ARE NOT A “CROSSWALK” they are a guide. All users should exercise CLINICAL judgement when choosing the appropriate code or codes to map between ICD-9 and ICD-10. In Laymans terms: THE GEMS are not a substitute for a COMPLETE system Change to ICD-10. Get your PHYSICIANS involved. As you know VISIT your resources like […]
ICD-10 | Medical Billing & Payers ICD-10: OCT. 1, 2014: Are YOU READY OR NOT ? Implementation Clearing House::::: Things to ask 1. Do you anticipate any pricing changes for your services due to the switch to ICD-10? 2. Where is your organization in the transition process? 3. Have you updated your system to Version […]
ICD-10 | Medical Billing & Payers ICD-10: OCT. 1, 2014: Are YOU READY OR NOT ? LETS TALK TRAINING One Cannot prepare enough– GET ON THE TRAIN TASK: 1. Identify staff members ( including clinical staff) who need training on ICD-10 2. Identify the level of training each job function will need 3. Identify the […]
ICD-10 | Medical Billing & Payers Are YOU READY OR NOT ? Step one Plan & Assessment PROJECT PLAN: Gain an overall understanding of the impact headed your way. Go to Professional Associations. ie. AMA, AAPC, AAFP, APMA, etc. Become familiar with ICD-10 requirements & tools to assist you. Human Capital Investment: Identify your project […]
ICD-10 is revealing some of the more obscure nuances of the Healthcare industry. While all providers and clearinghouses must comply with ICD-10 regulations as ‘covered entities’ under the Health Insurance Portability and Accountability Act (HIPAA), not all payers are required to. Worker’s compensation (WC), disability insurance, and auto insurance payers are not covered by HIPAA, […]