Find out whether you’re doing all you must to avoid costly violations. You’ve probably noticed plenty of websites asking you to accept “cookies” or rejoin email lists this summer. That’s because the EU’s General Data Protection Regulation (GDPR) took effect May 25. Designed to give European citizens more say over how their personal information is … Read more
Don’t ignore clues to improvement in the frustrating claims that come back. In some contexts, 5-10% might not seem like much. In U.S. healthcare, however, 5-10% is the average medical claim denial rate, and it means a lot of lost time and money for hard-working providers like you. What percentage of your submitted claims are … Read more
Exercise this option to support higher CPT® codes when needed. In their paper arguing for longer “routine” primary care visits, Dr. Mark Linzer and colleagues describe “[a] 78-year-old widow with hypertension, osteoarthritis, a recent stroke, elevated cholesterol, and a 50-pack-year smoking history [who] comes to her primary care provider for a mild cough and weight … Read more
Keep these perennial pitfalls in mind for your internal auditing. The AAFP tells healthcare organizations keeping their error rate (the percentage of claims payers deny) below 5% is “desirable.” Hitting that target is hard. One consultant and auditor, Jacqueline Thelian, told For the Record she’d seen “maybe five clients” reach 95% accuracy in 27 years. … Read more
Discover two coders’ keys for getting better information from doctors. What advice would you give the medical coder who asks, “My doctor only wants to list the primary diagnosis. How can I convince her to document the significant comorbidities?” It’s a common problem. When physicians perform health risk assessments of Medicare beneficiaries, comorbidities and other … Read more
Discover How to Avoid Frustration Coders and Physicians Face If you’re a medical coder or coding administrator feeling frustrated by “incomplete and nonspecific” documentation… Or fed up with patient charts “replete with errors and discrepancies”… Or you despair of bridging a “communication divide” between coders and physicians… …you’re not alone! These frank descriptions come from … Read more