The Hierarchical Condition Categories (HCC) was developed and implemented by The Centers for Medicate and Medicaid (CMS) in order to create a risk adjustment methodology to provide adequate payment plans for patients opting for private health care. These codes are primarily based on the health expenditure risk profiles of the Medicare Advantage (MA) plan members;
Dealing with medical bills is one of the leading concerns of physicians and health care professionals. Attempting to deal with such complex and ever changing medical billing and coding practices by themselves is a tedious process indeed. This measure is increased manifold when dealing with cardiology billing. This is a highly specific area of medical billing and requires specialized training and experience that helps maintain a fair degree of accuracy and reliability.
CPT is short for Current Procedural Terminology, and is a set of medical codes that defines a slew of medical related procedures and services to physicians, health insurance companies and accreditation agencies. CPT procedures operate closely with ICD-9 and ICD-10 diagnostic coding, except it defines the services rendered, while the ICD coding focuses more in the diagnosis on the claim.
The latter end of 2015 saw a significant change in medical coding. The standard ICD-9 (International Classification of diseases, Ninth Division), which had been in use for over three decades was upgraded to ICD-10. This new classification comes with a set of significant upgrades and changes, for example ICD-10 coding uses a wider,
Medical billing is a tedious and challenging job that needs special attention in order to ensure optimal competence. Although most doctors and hospital have an in house billing staff or get it done themselves, they are hardly qualified or trained to oversee the intricacies of billing efficiently. This is why it is important to invest in the services of a quality healthcare billing company.
It was the best of times. It was the worst of times. As Harris peered into his infant baby’s crib, tears welled up in his eyes. For the first time since his daughter was born a week back, she was breathing on her own. It was their third baby in 5 years. His previous children,
Broadly defined as the health outcome of specific groups of people, population health management is making significant strides due to the various integrated delivery systems which include hospital-based readmission prevention programs, patient-centered medical homes and accountable care organizations.
Increasingly being used to target high risk populations, the population health management approach exhibits a significant overlap with existing care management programs.
Although one of the often used terms in the healthcare industry; population health management is also one of the least understood. The industry uses the term to cover everything from big data analytics projects to basic team-based care initiatives. However, in order to implement the Triple Aim, healthcare organizations and professionals need to know and understand population health management.
Population health and public health are amongst the most popular buzzwords in the healthcare delivery sector today. Although both the terms appear to sound and mean the same, they are definitely two different concepts in both their meaning and application.
Population health and public health equally value the community’s well being. The primary task for both is examining health trends and evaluating causes of health conditions in the community.
Have you ever experienced a situation when you have been made to pay a bill twice for the same product? This is exactly what is happening in the healthcare industry. According to a recent study published in the New England Journal of Medicine, surprise medical bills have been presented to 22% of ER visits or Emergency Room visits.