Medscape Medical News, 2014-08-19 Marcia Frellick Despite common assumptions that larger practices offer better care, a new study finds that those with 1 to 2 physicians had 33% fewer preventable hospital admissions than practices with 10 to 19 physicians. Practices with 3 to 9 physicians had 27% fewer admissions. In addition, physician-owned practices had fewer… Continue Reading
News
HSMN’s Start 10 Program Is Working During This Pause by the Congress
HSMN’s Clients have welcomed the pause, but pause is an opportunity to carefully think through what is really needed to be successful in 2015. Data from the Studies we have done on the aggregate of HSMN’s client base show that the revenue cycle of some hospitals are projected to see an impact of a negative… Continue Reading
Healthcare Legislation Proposed Requires “Cook Book” Medicine
According to CMS, physicians who provide care to Medicare and Medicaid recipients would be granted increased liability protection “if they can demonstrate that they followed Established clinical guidelines based on a bill introduced in Congress recently”. “The Saving Lives, Saving Costs Act” would create a “Safe Harbor” for physicians who “follow best practice guidelines”. This… Continue Reading
Medicare Seeks to Expel Physicians from Its Program for Billing Medically Unnecessary Services
This Week Health Systems Management Network, Inc. is reporting that “Medicare seeks to fine and Expel Recalcitrant Providers”. The reason they seek to do this is that, in their opinion, physicians are billing for “Medically Unnecessary” services. According to CMS physicians do this despite knowing better. So a new program, “recalcitrant providers” has begun and… Continue Reading
Should Hospitals Take Coders Offline for Training in ICD-10-CM/PCS?
Many of HSMN’s clients have decided that they needed to take their coders off line and put them into intensive training for ICD 10-CM/PCS. In order to do that HSMN’s clients needed to know whether they could find a group who could in every way replicate the quality and productivity of the internal staff. HSMN… Continue Reading
What The OIG Wants Medicare to do to Find Fraud Among EHR Users
Health Systems Management Network, Inc. has been advising clients for 30 years through every iteration of coding and clinical documentation requirements including our most recent one (see our article on clinical documentation) advising our clients that “Cut and Paste” documentation is not only a compliance problem today but also for the transition from ICD-9 to… Continue Reading
Here’s Looking at You and You, and You, Kid
HSMN has had reports from several of its client hospitals asking us to come in and review cases that have been identified for audit. These have not been RAC audits but reviews by third party payors who want to compare the hospital documentation and coding to the physicians who performed the service and or the… Continue Reading
What CEOs and CFOs Need to Know About the ICD-10 Transition
What is the difference between ICD-9-CM and ICD-10-CM? It’s a huge one, and it’s one that requires a marriage between critical thinking skills and the thinking that goes into medical decision making. In other words, the clinical staff will need hands-on efforts to master the new scenario which requires a level of specificity never required… Continue Reading
Tuning up the Revenue Cycle and Medical staff for the ICD-10 Transition Through Outsourced Coding/Auditing
We are recommending to our clients, especially those whose reimbursement and revenues have declined, that they take decisive action to both stem the bleeding and focus on improvements. HSMN’s advice has appeared in a number of articles since last fall. Essentially they can be summarized as follows: Do not rely only on the “Systems” and… Continue Reading
Our Tried & True Revenue Cycle Management Success Formula
Health Systems Management Network, Inc. is proud to announce our new program called Back to Basics and more. We are elated to inform you that the search for the ultimate revenue cycle management process is over. Our 27 years of experience working with a wide variety of healthcare organizations has allowed us to develop a… Continue Reading