Group health plans with 50 or more participants, including self-insured plans, must be able to conduct electronic transactions in accordance with HHS standards and operating rules. One of the more challenging aspects of the electronic transaction rules has been the transition to the new International Classification of Diseases, 10th Revision (ICD-10) codes for health claims. Read the source article at National Law Review
Depending on your perspective, there’s some good news and some bad news for healthcare providers and patients who rely on Medicare for their financial and physical health: cost cutting measures encouraged by the Affordable Care Act (ACA), the transition to pay-for-performance reimbursement, and slower growth of overall healthcare spending means that the nation’s largest payer has extended its shelf life. The main hospital insurance
The process of constructing codes in ICD-10-PCS is designed to be logical and consistent: individual letters and numbers called "values" are selected in sequence to occupy the seven spaces of the code, called "characters. " In ICD-10-PCS sections 0 through F, the fourth character defines the body part, body system, body region, or treatment site – i.e., the specific anatomical site where the procedure or service is performed.
Let me start with a prediction – if CMS’ Proposed Rule simply mandates an industry-wide compliance with ICD-10 as of October 2015, ICD-10 will eventually be delayed again.
“Patient Engagement” is a big buzzword these days and can come in multiple forms, but too little is said about how to actually achieve it. From patient portals to patient loyalty programs — healthcare is seeing solutions similar to their cousins in the retail and banking sectors, all geared to incentivize patients in various ways to increase their consumption of healthcare. But do they work?
The FDA’s latest mHealth draft guidance reduces approval requirements for certain mobile devices. The agency proposes to largely deregulate a sizable list of Class II and Class I medical devices and no longer require their makers go through the 510(k) process. “This is big news, and a huge boost to the mobile health industry,” the mHealth Regulatory Coalition’s Bradley Merrill Thompson wrote MobiHealthNews in an email.
On July 16, 2013, CMS announced the first year outcomes from the Pioneer ACO Demonstration Project. While CMS presented the results as generally positive, financial details were not disclosed on all of the participating organizations, and CMS’ initial press release included the results of just 15 of the 32 Pioneer ACOs.
By combing through various analyst reports from organizations like Triple Tree Advisors and reviewing media reports, we have been able to pull together a little more detail.
First Some Background
The information in this article was provided by trainRX in their October Newsletter. ICD-10 - 12 months left to meet the Oct. 1, 2014 Deadline! Let's take a look at the true cost of this complex conversion to ICD-10 The true cost of the ICD-10 transition may not be as easy to calculate as you think. Take a look at the list below to make sure you've put everything in your budget.
We are now two weeks into the launch of the Healthcare Exchanges created as part of the new Affordable Care Act. The Exchanges were launched in an effort to enable individuals and families to compare options and purchase health insurance. The ACA mandates that everyone has health insurance (employer-based, government-sponsored or individually purchased) by March 2014 or face a penalty of up to 1% of their annual family income in 2014. Penalties eventually scale to 2.5% in 2016. Insurance premiums may be subsidized depending on a family’s income.
Hospitals are actively buying physician practices in the hopes of being prepared for the future as reimbursement strategies shift to payments based on bundled services and incorporate increased risk sharing.