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JAMA: Integrated Care Improves Patient Outcomes & Reduces Costs

A worldwide trend in healthcare reforms and new organizational arrangements, integrated care (also known as comprehensive care, transmural care, co-ordinated care or seamless care) focuses on more integrated and co-ordinated forms of care provision.  According to the WHO, “Integrated care is a concept bringing together inputs, delivery, management and organization of services related to diagnosis,

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Patients Top Complaint: Customer Service

Identifying keywords from about 35,000 Google+ reviews of physicians that were most commonly associated with the rating levels given, a marketing and public relations firm for specialty medical practices, conducted a study of patient complaints regarding physician offices. Published in the Journal of Medical Practice Management, the study reveals that the majority of patient complaints are about customer service at the physician’s office.

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ICD-10 Flexibilities to end October 1st

After ICD-10 went live on October 1, 2015; CMS (Centers for Medicare and Medicaid Services) allowed a one year grace period for ICD-10 flexibility, to overcome the strong opposition from the AMA (American Medical Association) to ICD-10 implementation. For the one year period, even though a more specific code existed, CMS allowed healthcare providers to submit claims with a valid code from the ICD-10 three character category,

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HIMSS: One-third Clinicians still use manual Claims Denial Management

Claim submission and denial management are critical components to the revenue cycle of healthcare facilities.  As regulations are getting more stringent with the transition to value-based care, healthcare providers are facing an increase in claim denials.  It therefore comes as a surprise that nearly one-third of clinicians are still using manual processes to manage their claim denials. 

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HHS ‘A Bill You Can Understand’ Challenge

Most patients and their families find it very difficult to understand their medical billing documents.  Currently, there are no established standards for consumer medical billing documents and patients often receive multiple bills for the same episode of care, albeit varying in content and presentation, from different doctors, labs and hospitals.  This makes it very difficult for the patient and their families to tally the bills;

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ICD-10-CM Code (M62.84) for Sarcopenia Announced

Effective October 01, 2016, the code M62.84 will be used by the healthcare community for sarcopenia, thus recognizing it as a distinctly reportable condition.  The AIM (Aging in Motion Coalition) announced this ICD-10-C code, as established by the CDC (Centers for Disease Control and Prevention).

What is Sarcopenia?

Defined as a combination of low muscle mass,

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Florida Hospital Gains $72.5 Million Courtesy its Clinical Documentation Improvement Program

Once an informal process that received significant attention at just a few hospitals; Clinical Documentation Improvement (CDI) is now the backbone of an organizations financial viability.  Essential for patient safety, proper and accurate reimbursement, quality ratings and more, a strong CDI program will ensure documentation integrity – a key factor in the ICD-10 transition. 

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