Wednesday 7 December 2016

MACRA facts that every clinician should know

MACRA is here and the new program is going to sunset several (un) popular programs such as Meaningful Use and the Value Based Payment Modifier model. Everybody who is anybody is busy discussing about MACRA and its ramifications. But as with any big updates the myths are jostling for space with the facts. We’ve sifted the facts from the myths for you.
Myth #1: MACRA will make maintenance of certification mandatory

Fact #1: MACRA doesn’t make it mandatory for physicians to participate in maintenance of certification. It is certainly not compulsory.

Myth #2: MACRA will affect only physician reimbursement.

Fact #2: There is a common myth that MACRA will only affect physician reimbursements. It will affect the reimbursement of all eligible clinicians. The eligible clinicians who will have to report under MIPS are physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurses and anesthetists.

Myth #3: Clinicians can choose between MIPS and  participating in AAPMs right at the outset.

Fact #3: All eligible clinicians will report under MIPS during the first year. CMS will select qualifying physicians to participate in AAPMs after evaluating their quality scores.

Myth #4: MIPS penalties are higher than the current quality measure programs

Fact #4: MIPS stream lines and consolidates 4 different programs under one umbrella. Instead of paying separate and sometimes expensive penalties for failing to meet different pay for performance programs, clinicians who report under MIPS will only have to pay a 4% penalty during the first year.

Myth #5: MACRA will penalize physicians who follow the fee for service model

Fact #5: It does not. Physicians can still choose to continue working with the FFS model can still participate in the MIPS program.

Click on the image below to enlarge
MACRA Myths and Facts


Tuesday 25 October 2016

Healthcare CFO's Top Challenges

“We really do believe much harder times are coming from a reimbursement standpoint”, Daniel Morissette, Stanford Health Care CFO.
With value based model, the most unpredictable payment reform, in their list of financial challenges, CFOs point out their threats and decision making factors.
“We’re trying to evaluate all of the different services we have and evaluate how they will fit into what we believe is the future of healthcare”, Donald Longpre, CFO, North Ottawa Community Health System
“It’s not just the fact that we’re going to get paid less for what we’re doing. We’re also seeing a shift in business,” Chris Bergman, CFO, Christ Hospital Network, Cincinnati. CMS is nipping at little things”, Bergman said on what was worrying him.
When it comes to experience:
“You need to understand the issues, test your theories, and subtly verify your assumptions along the way,” says Tom Gibney, CFO of St. Luke’s Cornwall Hospital of Newburgh, New York, when asked about how experience plays a role in decision making. “The buck stops with you,” he says. “The board is looking to you for answers”, he quoted.
Reimbursement declines, physicians shortage, healthcare reforms and other factors have forced CFO’s to use their experience in answering how to recoup the losses and improve the organization’s cash flow.
We organized the data collected from recent surveys to find out the challenges of healthcare CFOs in a value based era and the factors which influence their decision. Based on the results here’s a data driven answer.
 Healthcare CFO'S

Wednesday 7 September 2016

how our ICD-9 code conversion to icd 10 tool works

Type in the ICD-9 code you need an ICD-10 match for. Once you enter the ICD-9 code the ICD-10 mapping results will be displayed below the search box. Every ICD-9 to ICD-10 mapping is created based on thorough analysis by our certified coding experts.



There may be one-to one mapping to certain ICD-9 –ICD-10 searches or multiple mapping results. When there are multiple mappings provided, rely on your clinical documentation to arrive at the accurate code. If your search ends up in a "no record found" alert, please verify the accuracy of the ICD-9 code entered.

Source On: Medical billing star