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Optimizing Revenue Cycle Management and Clinical Documentation Integrity To Avoid Coding Disasters

Relias

As a senior industry advisor with MGMA, Veronica Bradley, CPC, CPMA, recently audited medical coding at outpatient clinics. The audit looked at outpatient evaluation and management (E/M) codes and in-office procedural coding and diagnoses codes using ICD-10-CM.

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Optimizing Revenue Cycle Management and Clinical Documentation Integrity To Avoid Coding Disasters

Relias

As a senior industry advisor with MGMA, Veronica Bradley, CPC, CPMA, recently audited medical coding at outpatient clinics. The audit looked at outpatient evaluation and management (E/M) codes and in-office procedural coding and diagnoses codes using ICD-10-CM.

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Is Medical Billing and Coding a Good Career Choice in 2024?

Northwest Career College

What is Medical Billing and Coding? Medical billing and coding are essential processes in the healthcare industry. Medical coding involves translating medical diagnoses, procedures, and supplies into universal alphanumeric codes for billing and insurance purposes.

Billing 40
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What You Need To Know About Value-Based Payment Models

Relias

But momentum will continue, since the Centers for Medicare and Medicaid Services (CMS) announced in 2021 that it plans to transition fully to value-based reimbursement by 2030. More healthcare organizations are now tying physician compensation to quality performance metrics, up from 26% in 2016 to 42% in 2021.

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The Impact of AI on Revenue Cycle Management: Transforming Healthcare Reimbursements

ACMA Blog

Through enhanced coding and charge capture, these algorithms analyze clinical documentation to propose precise medical codes, minimizing the risk of undercoding or overcoding while ensuring comprehensive coverage of billable services. Published online April 28, 2021. Information Systems Frontiers. doi: [link]

Billing 40
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Does the Hospital Price Transparency Rule Increase Your Audit Risk?

Relias

As a result, the Centers for Medicare and Medicaid Services (CMS) public rule on price transparency requirements for hospitals came into effect on January 1, 2021. An executive order passed in 2019 directed the Department of Health and Human Services to create new guidelines to help reduce healthcare costs.