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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...

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Embracing 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...

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Last 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...

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Preparing 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...

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The 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...

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Improving 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...

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Using 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...

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The 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...

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The “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...

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The 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....

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Drones 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...

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Value-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...

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Seasonal 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...

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Healthcare 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...

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MEDTranDirect 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...

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A 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...

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The 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...

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Back 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...

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Healthcare 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...

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CMS 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...

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