Medicare Revalidation in 5 Steps

As per Section 6401 (a) of the Affordable Care Act, all enrolled providers and suppliers are required to revalidate their Medicare enrollment information under the new enrollment screening criteria.

The Revalidation Process

  1. Determine which provider is being requested to revalidate
  2. View the information checklist
  3. Revalidate using Internet-based PECOS or by completing the appropriate CMS-855 application
  4. Check your application status

PECOS is the most efficient way to submit your revalidation information.  

Read More

2017 Benefit and Payment Parameters – Part 2

In continuation of our previous article on the Benefit and Payment Parameters for 2017, given below are further highlights of some of the policies in the final rule.

Market Rules

Student Health Insurance Plans
Risk pool must be based on bona fide school related classification and not on health status if issuers of student health insurance plans wish to establish one or more separate risk pools for each individual college or university. 

Read More

affordable care act to provide Health insurance coverage

2017 Benefit and Payment Parameters – Part 1

Released on February 29, 2016, the final Health and Human Services (HHS) Notice of Benefit and Payment Parameters for 2017, sets standards for Health Insurance issuers and marketplaces which includes payment parameters, establishes new standards for improving consumers’ marketplace experience, promote continuity and stability in the marketplaces and ensures affordable and accessible coverage.

Read More

Multitude of EHR Notifications Adding To Physician Burnout

It takes just a jiffy to send an online message – compare that to the days gone by, when paper-based systems made sending messages an onerous task.  That is an improvement in our fast paced world today, or is it?  The ease and speed of instant messages has resulted in people sending and receiving far too many messages which take more time and concentration to read,

Read More

5,500 New ICD-10 Codes from October 2016

The medical billing coding system is about to get larger and tougher – with Centers for Disease Control and Prevention (CDC) and Centers for Medicare and Medicaid Services (CMS) adding 1900 diagnosis codes and 3651 hospital inpatient procedure codes to the ICD-10 coding system for fiscal year 2017.  As it is, there are 68000 billing codes under ICD-10,

Read More

Preventing Medical Overbilling and Mis-billing

Medical billing is one area that most healthcare facilities find nerve wracking, time consuming, complicated and tricky.  With all those rules to follow, codes that need to be put in correctly and supporting documents to be attached, medical billing is an area that is highly prone to mistakes.  Typically these mistakes are due to carelessness,

Read More

Ways To Prevent Medical Billing Fraud

Have you ever been a victim of medical billing fraud?  Medical billing fraud, especially those related to insurance billing are far more common in practices than you would think.  There are cases of willful fraud committed as well as those that are committed without even knowing it.  In either case, the onus of the fraud and its legal consequences rests on the practice. 

Read More

Do EHR Design Flaws Lead to Errors In The Emergency Room?

Information Technology and computers are supposed to make our work easier, faster and accurate.  However, the transition to digitized record systems seems to be causing a whole new category of patient safety errors.  From ordering medication dosages larger than required to making entries in the wrong patient’s records – are these user errors in the making or are they due to a poor system design?

Read More

Survey Reveals Top Population Health Management Challenges

Population Health Management using health IT is one of the biggest goals for healthcare providers, in the current healthcare landscape.  A survey conducted by HIMSS Media on behalf of Royal Philips highlights how healthcare professionals are using connected health technology in the context of population health management.  The survey covering 105 leaders in healthcare IT shows that the majority of health systems seeking to improve patient outcomes have already implemented population health management systems. 

Read More