Category Archives: Uncategorized

New Opportunities in Physician and Hospital Reimbursement

HSMN, a leading ICD-10-CM/PCS consulting firm, is advising their clients of new revenue cycle opportunities. They are predicting hospital and physician reimbursement will decline due to the PPACA but there are opportunities in reimbursement to regain the loss that may be missed if medical staff clinical documentation, coding and critical thinking coders don’t interact in… Continue Reading

Transitioning the Medical Staff and the Revenue Cycle Management Team in a Concurrent and Seamless Process.

“The best revenue cycle management consulting firm you’ve never heard of.” HSMN has successfully worked with academic medical centers, faculty and group practices and community hospitals in helping them successfully transition to every iteration of reimbursement, coding and claims management since 1987.  During that period we have worked closely with the medical staffs of these… Continue Reading

Health Care Providers – Don’t Delay Your Transition to ICD-10 Due to Recently Announced ACA Mandate Date Changes

The White House recently announced that the implementation of certain provisions of the Affordable Care Act would be delayed until 2015. These provisions affect only companies’ mandate to provide coverage to their employees.  But this does not change the need for health care providers to prepare themselves for the transition from ICD-9 to ICD-10. Automation… Continue Reading

Physician Practice Management Reimbursement, Clinical documentation and Coding

In a recent article just published in the Wall St. Journal, (“Should Physician Pay be tied to Performance?”) two points of view were expressed; the first stated that companies like Health Care Incentives Improvement Institute argue that there are enough bench marks for quality to begin paying Physicians based on outcome.  The second opinion expressed… Continue Reading

Can a Program to Improve Clinical Documentation and Coding Secure Appropriate Assignment of Patient Status and Elimination of Medicare Penalties for Readmission

Questions are being raised about the validity of Medicare’s 30 day readmissions data currently being reported coincidental with the penalties for hospital readmissions rising from 1% of total Medicare funding based on how many patients returned for care within 30 days to 3%.  These are serious detriments to hospitals’ declining margins.  Heart failure, heart attack… Continue Reading

Integration of Care Must be reflected in the New Clinical Documentation Paradigm

Many private practice Clinicians and those on Medical staffs, especially those in Faculty Practices are struggling to find the proper balance between integrating Patient Care and achieving a high degree of proficiency in doing ICD-10-CM/PCS Claims.  Is there a dichotomy between those goals of Integrated Patient Care Management and satisfying the kind of specificity and… Continue Reading

An Audit of Clinical Documentation Practices and Coding is the first step in a successful or transition to the world of ICD-10-CM for the Medical Staff

Many of Health Systems Management Network’s (HSMN) clients have asked what Systems they should buy to transition to the ICD-10-CM /PCS Coding in 2014.  HSMN’s answer and one which we have given over a period of 30 years is “It’s the Clinical Documentation Mr. CFO”.   Every hospital’s Clinical staff, and particularly individual clinical disciplines, have… Continue Reading

ICD-10-CM Preparation and Data Analytics Consulting Now Offered by Health Systems Management Network, Inc.

HSMN has previously announced their Start Ten Plus Program that combines transitioning Medical staff to ICD-10-CM and creating partnerships with skilled coders who use critical thinking skills and creating an internal clinical documentation improvement program with and for the Medical staff. One aspect often neglected that is important and perhaps the most critical element is… Continue Reading

Hospital Billing and the new Penalties under the Affordable Care Act which will be in place in 2015

The Wall St. Journal in a recent article by Stephen Soumerai and Ross Koppel stated that CMS is very focused on reducing rates of readmission of Medicare/Medicaid patients.  They draw the following conclusions: 1) Research shows that most readmissions can’t be prevented; 2) Readmission penalties which will be 1%-3% starting in 2015 will incentivize hospitals… Continue Reading