10 Steps for Failsafe Charge Data Management

Busy revenue cycle teams often overlook the basic steps of charge data management to attend to more urgent priorities. These proven steps covered in this article are pivotal to keeping “charge data management” a key operational priority.

E&M Payment Policy Changes Drive Modest Reduction in Specialist/Primary Physician Pay Gap

Have the federal payment policy adjustments implemented in 2021 meaningfully reduced the pay gap between specialists and primary care physicians (PCPs)? A recent JAMA study appears to have yielded the answer: yes—but not by nearly enough.

Transcatheter Valvular Procedure Code Set Updates

Over the last decade, one of the most exciting areas of development in healthcare has been the growth of structural heart and interventional cardiology programs—specifically, the advancement of transcatheter valvular procedure techniques. As the ability to treat a larger population using these novel techniques expands, so must our understanding of the nuances involved in navigating the current rules and regulations from both the clinical and revenue cycle perspectives.

Eight Steps to Reveal Incremental Revenue and Reduce Risk Related to “Lesser-of” and “Stop-Loss” Contract Clauses

Restructuring a hospital’s chargemaster in this era of transparent pricing often results in material increases and decreases in line item charges to align with market norms, unit costs, or a hybrid thereof. Learn how your organization can enhance its financial performance in this environment.

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Hospital Zero-Base Pricing®: A Novel Approach to Establishing Rational Chargemaster Prices

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On-Demand Webinar: Optimize Hospital Inpatient and Outpatient Audits

In our current auditing environment, the importance of maintaining an internal audit plan for facility services cannot be overstated. Watch our complimentary on-demand webinar to learn how leveraging technology can help you review all of your claims or coding abstract data and uncover revenue opportunities, allowing you to focus your time and investment on problem areas.

2023 E&M Updates Resources

Wondering how the 2023 updates to E&M guidelines affect your team? Look no further. Our experts have developed a set of customized resources to aid professionals as they put the guidelines into practice.

Big Changes in 2023 for Ambulatory Surgery Centers

The Centers for Medicare and Medicaid Services (CMS) have created over 50 new C-codes (C7500–C7555) for ambulatory surgery centers (ASCs) that affect many procedures. These codes were created to allow additional payment for packaged services for ASCs.

How to Stay Ahead of Payer Audits by Data Mining Your Claims

External audits are rapidly returning to full operating force following a lull that took place amid the worst of the COVID-19 pandemic. Amidst a time of shrinking operating margins and heightened scrutiny by federal healthcare contractors, providers are seeking to focus on the benefits of technology-driven internal auditing.

How to Rationalize Chargemaster Prices

Have you ever wondered how hospital prices became so irrational? As is often the case, things changed incrementally. Hospitals and healthcare systems have experienced years of inadequate inflationary update factors, often reduced by factors such as presumed over-coding under the federal inpatient and outpatient prospective payment systems.

Is Your Staff Struggling with How to Bill Lab Services? 4 Steps to Better Results

If your organization is struggling with coding laboratory services consistently and accurately, here are the four steps you need to take.