The Impact of CMS Flexibility on ICD10 Implementation
CMS announced a joint statement with the AMA in early July regarding a compromise on how claims with 10 codes would be processed after 10/1/15. They published FAQs and responses for this announcement...
View ArticleEmbracing Disruption for Growth
As we approach the October deadline for ICD10, you can sense the tension in the industry as the unknown consequences of using this code set move closer to the present as each day passes, or as Snoopy...
View ArticleLast Minute ICD10 Testing Opportunities
CMS has finished the third and final round of end-to-end testing for claims containing ICD10 codes. The tests results included an 87% acceptance rate of the claims submitted. Only 1.8% of the claims...
View ArticlePreparing for the Transition to Value-Based Payments
One thing I have learned over my 30 years in healthcare IT is that our industry will fight against change with its last breath, regardless of the logic or benefits of any new process that might be...
View ArticleThe Value Proposition of Hospice Transfers under Medicare Reimbursement
“Medicare coverage of hospice depends on a physician’s certification that an individual’s prognosis is a life expectancy of six months or less if the terminal illness runs its normal course.” This is...
View ArticleImproving the Processing of NOEs and NOTRs for Hospices
As a vendor of eligibility processing services and a NSV (Network Service Vendor) for the Medicare HETS eligibility system, we have a vested interest in the capability of these systems to provide...
View ArticleUsing Modems for Medicare Connectivity
MEDTranDirect provides connectivity between healthcare providers and all the Medicare contractors (MACs). Through this connection, providers can have access to the Direct Data Entry (DDE) or FISS...
View ArticleThe Recovery Audit Program: The Big Business of Medicare Audits
The MACs (Medicare Administrative Contractors) audit claims submitted by providers within their jurisdictions. These organizations are mostly insurance companies who administer the contracts awarded...
View ArticleThe “Sticky” NOE Problem
MEDTranDirect is a vendor of Medicare connectivity services, including access to the CMS HETS system (HIPAA Eligibility Transaction System) that provides real time eligibility data for healthcare...
View ArticleThe Double Standard for Healthcare Data
Healthcare providers collect an extensive amount of data regarding their patient’s medical history. Most providers understand the importance of maintaining accurate and complete health records....
View ArticleDrones and Healthcare IT
It has been a month since my last post. I normally don’t take so long, but sometimes life takes over and you don’t always have the free time to get your thoughts down on virtual paper. Although my...
View ArticleValue-Based Payments Can and Will Break Traditional Patient Accounting Systems
The Affordable Care Act includes many healthcare regulations unrelated to the distribution of insurance and expanding Medicaid. One important part of this legislation allows the federal government to...
View ArticleSeasonal Discharge Rates for Hospices
As we discussed in my last article, the ACA has allowed CMS to explore new payment models that might more accurately reflect the value or cost of the services rendered by healthcare providers. For...
View ArticleHealthcare Analytics – Analyzing the Cookie Jar
Healthcare analytics can be used to identify successful treatments, control costs, and make processes more efficient. It can also be used to shed light on practices and industry relationships that...
View ArticleMEDTranDirect Takes on Late NOEs with the New NOE Tracker
Since October of 2014, timely filing of NOE/NOTRs (Notice of Election/Notice of Termination-Revocation) has been a leading issue for the hospice industry. As a software company that works on Medicare...
View ArticleA Summary of Pre-Claim Review for Home Health Agencies
By now, home health agencies are well aware of the new program under development by CMS to crack down on what they believe is a major problem with improper payments for their services. This is...
View ArticleThe Two Faces of CMS IT
As I mentioned in last week’s article, I attended the Healthcare Analytics symposium in Chicago a couple weeks ago. During this meeting, Niall Brennan, CMS Chief Data Officer, spoke about recent...
View ArticleBack to Work – Reconnecting with the NOE Processing Problem
Hello everyone. First, I apologize for the long break in blog activity. A year ago, I retired as president of MEDTranDirect. I am grateful for the year off and the opportunity to get some perspective...
View ArticleHealthcare Analytics: Exploring Data on Providers and the Industry
Data analytics is a hot topic in the healthcare industry. However, people throw this term around with little understanding of what it really means. Similar to “Big Data” and “Affordable Healthcare”, it...
View ArticleCMS 837i and NOE Tracker – A Process Comparison
CMS 837I vs. NOETracker On July 27, 2017, CMS issued Change Request 10064 describing a new process for submitting NOEs. This system, to be introduced in January of 2018, will allow hospices to use...
View Article
More Pages to Explore .....