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Payer Agreements are changing, and the language is getting much more aggressive. I just saw new language that allows the payer to LOWER a provider’s reimbursement by 20% if referrals are made to other providers who are Out of Network. For example, your reimbursement would be taxed 20% if you take a case to an…
DetailsHealthcare is at its core based on science. It is the science of accurately diagnosing and treating the sick and wounded. That being said, how can having more specific information be a bad thing? How can having more data from which to make decisions be a bad thing? Will it be a hard switch to…
DetailsX15.0XXA — Contact with hot stove (kitchen), initial encounter X15.1XXA — Contact with hot toaster, initial encounter Y93.G3 — Activity, cooking and baking Y27.2 — Contact with hot fluids In preparation for the upcoming deadline for ICD-10 implementation, RT Welter presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the…
DetailsCommunicating with healthcare payers is a process, one involving more than simply handing them a medical claim. Here are some tips to help with the process. Creating better relationships with your payers before Oct. 1, in fact, enables providers to glean important insights about testing results, changes to reimbursement, how to handle denied claims. Early…
DetailsR45.1 — Restlessness and agitation R45.2 — Unhappiness R45.3 — Demoralization and apathy R45.4 — Irritability and anger In preparation for the upcoming deadline for ICD-10 implementation, RT Welter presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed…
DetailsYour providers see waste in the system every day. Services that are done (by other providers and facilities), but not needed for a particular patient’s care—Make note of these! Use them when you sit down to re-negotiate your next rate increase with the payers. You don’t need the specific patients (this is protected information), you…
DetailsIn most markets half, or more, of the payer lives are in self-funded plans This means the “insurance company” is not really providing an Insured Product—they simply administer the plan. The actual payer, at the end of the day, is the employer themselves. All of these employers have a Human Resources Department (or something similar)…
DetailsThe United States Senate just passed the SGR Bill, which includes no indication of a further delay of the ICD-10 transition deadline. In a move that took over a decade to accomplish, the Senate voted 92-8 late Tuesday to repeal the sustainable growth rate (SGR) formula that adjusts Medicare payments to physicians. The bill, H.R.…
DetailsThis interactive and hands-on ICD-10 training is designed to prepare coders for the AAPC and AHIMA ICD-10 proficiency examinations. This training is also appropriate for experienced billers that perform coding as part of their job responsibilities. Participants will gain the tools they need to appropriately select ICD-10-CM codes. These training sessions will be coder centric,…
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