Author Archive

Money Up front: ACOs and The Advance Payment Model

Anticipating relatively high start-up costs, the Innovation Center of CMS developed the Advance Payment Model (APM) to complement the Shared Savings Program.  The APM is a limited model available to smaller ACOs that generally serve rural-based areas; however, the ACO may participate in either Shared Savings Program track. In order to qualify as an APM

CMS Audit Program Stats

For those interested in reviewing statistics related to the CMS Recovery Audit Program, please check out this page.  Here you will find numerous updates to different CMS programs including the Auditing Program.  Two things I found particularly interesting on this page include the Recovery Program Audit Summary and the Audit Program Appeals Update. The summary

MTBC’s Highly Anticipated OB/GYN EMR

With the latest trends in medicine, OB/GYN care has become safer and more successful. Medical professionals are dedicated to providing up-to-date care for both pregnant and non-pregnant patients. OB/GYNs provide preventive care to women and have specific expertise in pregnancy, childbirth, and disorders of the reproductive systems. MTBC’s specialized EHR changes the face of care

OB/GYN EHR: Another Remarkable Achievement

Today’s science and technology developments have changed the process of examining a patient. The arrival of the OB/GYN EHR has made enormous differences to the efficiency of OB/GYN practices. This software illustrates many benefits of electronic health records. Obstetrics is the medical practice for pregnant women and Gynecology is the medical practice of diagnosing problems

RAC audits – The Benefit of a Single Source

The Center for Medicare and Medicaid Services (CMS) aggressive stance for Meaningful Use leads to the common conclusion that Electronic Medical Records (EMRs) are the future of maintaining healthcare data. EMR technology has greatly simplified medical billing submission and created robust tracking capabilities that weren’t available in the past. With this easier access to data

CMS Pushing for Accountable Care Organizations

For those internet searching away for information on Accountable Care Organizations and the Medicare Shared Savings Program,  please ensure you are reviewing the final rules which were published on November 2, 2011.  The final rules relaxed many of the proposed rules in hopes of encouraging the formation of ACO.  One of the largest changes was

The RAC Audits are Coming!

RAC audits are becoming more common as auditors expand their reviews into additional states and specialties.  Many of the audits to date have been focused on hospitals and surgical practices due to the high revenues associated with these providers.  As the audits expand there are several things providers need to be aware of.  One of

ACO: Creating a Strong Foundation with a EHR

Accountable Care Organizations (ACOs) are meant to be a flexible payment and care delivery model that lowers total cost of care for patients using a group of coordinated health care providers. Hay Greens, a healthcare policy practice, recently released an article that outlined five preparatory actions to create a stable ACO. This article informs providers

HIE: The Future of Electronic Medical Records?

Health Information Exchanges (HIE) are organizations that synergize and effectively streamline health information records. Many state governments provide funding for HIE implementation with the goal of facilitating access to and retrieval of clinical data to provide more timely, focused, and equitable patient-centered care. Even today, the federal and state governments have not clearly defined the

Medicare Wellness Visits: One Visit a Year… But 3 Codes?

Thanks to the Affordable Care Act, Medicare is (finally) covering yearly preventative, or “wellness,” visits for patients; however, the annual visit is actually separated into three different encounters.   Although each visit is largely similar, there are a few minor details separating each visit, and, as you know, these minor details must be followed as it