Emergency Medicine

/Emergency Medicine

ICD-10 Denial Risk Sparks Revenue Growth Opportunity For Emergency Coding and Billing

2013-10-15T09:17:09+00:00

ICD-10 preparedness is more than just about meeting the Oct. 1, 2014 implementation deadline, it's about the possible impact to your emergency medical practice revenue cycle management following the "go live" if you're not. There's talk about a possible increase in denial rates during the transition, which can reduce practice profitability, or possibly even bring it to a screeching halt. Denial rates potentially could increase between 100 and 200 percent, AR days increase by 20 to 40 percent, prolonged declining payments and a near doubling of claim error rates. ICD-10 has prompted a Y2K response. That's because the transition from ICD-9 [...]

ICD-10 Denial Risk Sparks Revenue Growth Opportunity For Emergency Coding and Billing2013-10-15T09:17:09+00:00

Future PQRS Payments Require 2013 Reporting and Emergency Coding Expertise

2013-09-06T13:11:40+00:00

PQRS shows us that our payment system is moving in a new direction. Fee-for-volume is giving way to the new world of fee-for-value. That's why PQRS requirements are tied to your incentive payments and after 2014... payment penalties for failing to meet requirements. By not complying with Physician Quality Reporting System (PQRS) requirements, you're doing just that, placing yourself at risk for penalties that could reduce your hard earned revenue. According to a new study by The Harvey L. Neiman Health Policy Institute, "more than 80 percent of Medicare providers will face penalties for failing to meet quality thresholds if current [...]

Future PQRS Payments Require 2013 Reporting and Emergency Coding Expertise2013-09-06T13:11:40+00:00

Emergency Medicine ICD-10 Success Hinges on New Medical Coding and Billing Testing, Documentation

2013-08-29T15:26:36+00:00

Although the implementation deadline for ICD-10 is slated for Oct. 1, 2014, emergency physicians should begin now to prepare for the future implementation of ICD-10-CM coding by improving emergency department documentation. Not only does failure to fully and properly document a patient encounter has many medical, financial, and even regulatory ramifications, it will also significantly impede progress in moving to ICD-10. Documentation can be vague in some instances when it comes to the more definitive diagnoses. That's why the increased specificity and detail in ICD-10-CM codes is expected to be particularly relevant for the types of conditions treated by the emergency [...]

Emergency Medicine ICD-10 Success Hinges on New Medical Coding and Billing Testing, Documentation2013-08-29T15:26:36+00:00

Averting a Coding Emergency: ICD-10 Updates from CMS Avoid Confusion in Medical Coding and Billing

2013-08-12T11:47:05+00:00

Emergency medicine coding and billing can be more than a little confusing, especially when updates and clarifications are happening practically every day. Take CMS for example. Recently, they released several important clarifications because there's been some confusion and frustration regarding the codes in Chapter 20, External Causes of Morbidity (V, W, X, and Y codes), which will replace the current ICD-9-CM E-Code section. According to CMS as reported in an article from American Association of Professional Coders, "the Official ICD-10-CM Guidelines (I.C.20) state that for any initial encounter from an illness or adverse effect, the codes found in this chapter should [...]

Averting a Coding Emergency: ICD-10 Updates from CMS Avoid Confusion in Medical Coding and Billing2013-08-12T11:47:05+00:00

Heightened Overpayment Risk Mitigated with Emergency Coding Expertise

2013-06-20T09:32:00+00:00

In emergency medicine, you're at risk every day. With the dizzying array of procedures conducted in the ER, chances are good that inadequate, noncompliant documentation in medical practice billing will result leading to overbilling and high paid claim error rates. And with PPACA phasing in and ICD-10 looming...it's enough to make you feel faint and need a gurney in your own department. If there was ever a time when you needed a healthcare revenue cycle management team that understands the intricate nuances of emergency medicine coding, billing and collections, it's now, when CMS is increasing audits resulting from overpayments. When it [...]

Heightened Overpayment Risk Mitigated with Emergency Coding Expertise2013-06-20T09:32:00+00:00

ICD-10 Conversion Adds Codes, Detail to Emergency Medicine Revenue Cycle Management

2013-06-11T09:33:37+00:00

Within all the layers of detailed information you’re learning as you begin to convert your medical practice billing and coding to ICD-10 are the 68,000 diagnosis codes that include those you may not refer to every day. Say, for example, ICD-10’s introduction of 312 codes for injuries by animals. They include: W5922XA: Struck by a turtle, initial encounter W5609XA: Other contact with dolphin, initial encounter W58.11XA: Bitten by a crocodile, initial encounter W58.01XA: Bitten by alligator, initial encounter Then there are those for even more specific circumstances: X52XXXD: Prolonged stay in weightless environment, subsequent encounter V91.07XA: Burn due to water skis [...]

ICD-10 Conversion Adds Codes, Detail to Emergency Medicine Revenue Cycle Management2013-06-11T09:33:37+00:00

Your Chances of Tax Audits Tied to Emergency Medicine Revenue Cycle Management

2013-04-30T10:14:23+00:00

Say the word “audit” out loud and practically everyone within earshot will stop in their tracks. Filled with fear of this possibility, physicians are among those who top the list, and rightly so. According to a March 15 Physicians Practice article by Philippa Kennealy, MD and Philip Garrett Panitz, Esq., the Internal Revenue Service (IRS)’s audit enforcement is increasing among physicians based on the perception they make easy targets as a result of poor record-keeping practices. “Most physicians in medical practice have received some training in reducing their malpractice risk, but little or nothing is taught about how to minimize the [...]

Your Chances of Tax Audits Tied to Emergency Medicine Revenue Cycle Management2013-04-30T10:14:23+00:00

Emergency Physicians Facing Large Medicare Cuts Can Look to Emergency Medicine Coding and Billing to Help Manage Revenue

2013-01-07T23:53:16+00:00

The New Year arrives with an eleventh hour Congressional stop gap measure to avert a 26.5 percent reduction in the Medicare physician payment rates that would impact Emergency Medicine physicians – a temporary stop gap at best. Providers just missed facing the crippling effects on their clinical and operational efficiency as a result of the Sustainable Growth Rate (SGR) formula overshooting budgeted Medicare spending – for now. 2013 is an essential time for emergency medicine medical coding, billing and collections processes to support and champion new payment and delivery models that prepare for future Medicare cuts still anticipated. Now, more than [...]

Emergency Physicians Facing Large Medicare Cuts Can Look to Emergency Medicine Coding and Billing to Help Manage Revenue2013-01-07T23:53:16+00:00

Affordable Care Act Emerges with Changes to Emergency Medicine Revenue Cycle Management

2012-12-15T16:24:01+00:00

The role of Emergency Medicine is an essential and complex component of the Affordable Care Act and its focus on wellness and disease management. Yet Emergency Medicine revenue cycle management faces a future of mounting regulatory constraints, compliance issues, multi-faceted documentation...and changes in reimbursement models that impact medical coding and billing. In June 2012, the MGMA-ACMPE released the results of a questionnaire that ranked members' most pressing practice management challenges. No. 2 was: Preparing for reimbursement models that place a greater share of financial risk on the practice. Within the next five years, many Emergency Medicine physicians will be adopting this [...]

Affordable Care Act Emerges with Changes to Emergency Medicine Revenue Cycle Management2012-12-15T16:24:01+00:00

Emergency Medicine Revenue Cycle Management Requires a Plan to Address Unique Compliance Issues

2012-11-16T16:32:33+00:00

As experts in Emergency Medicine, you're ready to spring into action at a moment's notice. But are you ready to prepare and respond fully to compliance issues, and all the complexities of hospital based Emergency Medicine medical coding, billing and collections? You already know that having a compliance plan is of the utmost importance to the integrity and profitability of your Emergency Medicine practice. OIG recently released its 2013 work plan to help you identify areas of risk and key areas to avoid unintentional fraud, waste and abuse. To help you understand some of the changes on the horizon, the following [...]

Emergency Medicine Revenue Cycle Management Requires a Plan to Address Unique Compliance Issues2012-11-16T16:32:33+00:00