Medicare Accountable Care Organizations: Steps to Getting Started

While the excitement surrounding Medicare Accountable Care Organizations (ACO) is clearly reverberating throughout the physician community, there continues to be a significant knowledge gap regarding the basic steps that must be taken to form an ACO. While a blog cannot provide a full step-by-step guide to ‘getting started’, I will address the relevant key considerations

RAC Audits of E&M Codes to Begin for 15 States

In September the Center for Medicare and Medicaid Services announced that it will extend Recovery Auditor (RAC) review for Evaluation and Management (E&M) services to 15 states. These 15 states where the expansion is occurring are Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West

RAC Audit Checklist

The American Health Information Management Association (AHIMA) has a useful checklist, listed below, for providers facing a RAC audit. MTBC is committed to assist providers during audits by providing useful reports that can be located on our Practice Management site. A:  Create a RAC team Senior leadership Finance/revenue cycle Clinical documentation management Health information management

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 Penalties for Readmissions Create Additional Momentum Toward ACO Formation and EHR Utilization

Bonuses for successful accountable care organizations (ACO) have created quite a ‘buzz’ in the healthcare community. Two new developments – penalties for hospitals and quality of care data published online by the U.S. Department of Health and Human Services (HHS) – will build on this momentum and increasingly drive Accountable Care Organizations formation. Earlier this

Technology is Key to Achieving ACO Success

A study by America’s Health Insurance Plans (AHIP) found, “Technical assistance to providers has been identified as one of the key requirements to their success in accountable care arrangements.” See AHIP. MTBC’s suite of services is an ideal solution for providers interested in joining forces to create an Accountable Care Organization.  MTBC offers end-to-end revenue

Hospital Mergers & Acquisitions: Are ACOs a Cause or an Effect?

Over the last several years, the pace of mergers and acquisitions involving either hospitals purchasing physician practices or hospitals purchasing other hospitals has quickened exponentially. Some factors driving the consolidation in the healthcare industry are increasing overhead costs, decreasing reimbursement rates and hospitals’ reaction to the Patient Protection and Affordable Care Act (PPACA). What PPACA