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The Triple Aim: Improving the patient experience Improving the health of populations Reducing per-capita cost The Triple Aim is on all the payer’s minds these days. These three tenants are now being woven into many of the decisions being made about cost, quality, reimbursements, network size, etc. Using these three items in your contracting strategy…
DetailsThe Colorado Division of Workers’ Compensation (DOWC) recently issued final utilization standards and the final Colorado Workers’ Compensation Medical Fee Schedule that affect all workers’ compensation billing, and will go into effect January 1, 2016. Among several significant changes are that these rules and regulations require payers to adopt Medicare’s Resource-Based Relative Value Scale (RBRVS)…
DetailsAs part of the ongoing effort to educate providers about the most effective treatment protocols for workers’ compensation, Pinnacol Assurance is amending their SelectNet network credentialing standards for nurse practitioners and physician assistants practicing in the following urban counties: Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, El Paso, Elbert, Garfield, Jefferson, Larimer, Mesa, Pueblo, and Weld. Mid-level providers in…
DetailsColorado Medicaid and CHP+ Provider Revalidation & Enrollment Begins September 15, 2015 New federal regulations established by the Centers for Medicare and Medicaid Services (CMS) require enhanced screening and revalidation for all Medicare, Medicaid, and CHP+ providers. Beginning September 15, 2015, all Colorado providers who want to continue, or begin, providing services to Medicaid and…
DetailsS61.451A — Open bite of right hand, initial encounter W55.81XA — Bitten by mountain lion Y93.01 — Activity, hiking 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…
DetailsThe blood that keeps a practice alive: Pick a patient seen one month ago and follow that revenue cycle. Look at the claim, compare it to the notes, has it been paid? Did the patient pay a co-payment or deductible if so when? (Co-payments and deductibles should be paid at the time of service). Did…
DetailsOnce officially completely implemented, the ICD-10 transition will provide infinitely more descriptive codes for use in the realm of medical documentation, to both more accurately document ailments, treatments, and the like, as well as more easily allow for interoperability. Productivity Drop For years, critics have opposed ICD-10 in part out of fears of lost productivity—and…
DetailsT22.112A — Burn of first degree of left forearm, initial encounter X08.8XXA — Exposure to fire, initial encounter Y93.G2 — Activity, grilling 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…
DetailsSCOTUS rules: Regardless of your politics, it’s the law of the land. Same sex couples may now legally marry in all 50 states. Be sure your forms and procedures for spousal notification, sharing of information, etc. are up to date and accurate! These societal shifts seem to always follow with high profile missteps and mistakes. …
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