Hospital Outpatient Departments: Effective July 1, 2020 you must request prior authorization for certain hospital Outpatient Department (OPD) services

For dates of service beginning July 1, 2020, you must request prior authorization for the following hospital Outpatient Department (OPD) services: Blepharoplasty Botulinum toxin injections (when paired with specific procedure codes) Panniculectomy Rhinoplasty Vein ablation Medical necessity documentation requirements remain the same and hospital OPDs will receive a decision within 10 days. While only the […]

Saince announces the launch of tele-medicine feature within its clinical documentation solution

Doc-U-Scribe clinical documentation solution now comes integrated with tele-medicine workflow. Physicians and administrators can create tele-consultation sessions with patients seamlessly from within the application. This process eliminates the need for providers to use separate solutions – one for clinical documentation and another for video session. The COVID-19 public health crisis has accelerated the use of […]

When Pursuing CDI, Using Risk Adjustment Is Vital

As healthcare has moved away from fee-for-service reimbursement models toward a more value-based system, the idea of using risk adjustment to account for individual patient risk and chronic conditions has become far more important for providers seeking to maximize quality of care. In today’s healthcare environment, providers are often required to fight simultaneous battles on […]

EHRs, Documentation Leading to a Physician Burnout Crisis

Dictation and Transcription Improvements Cited as No. 1 Fix by Docs When they were kids thinking about their future career, physicians didn’t dream of taking care of administrative record-keeping. They dreamed about taking care of patients. But extensive documentation fatigue has become a leading concern for the healthcare industry. Just this week, the U.S. Department […]

Hospital OPPS and ASC Payment System and Quality Reporting Programs Changes for 2018

On November 1, CMS issued the CY 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule with comment period, which includes updates to the 2018 rates and quality provisions and other policy changes. CMS adopted a number of policies that will support care delivery; reduce burdens for health […]

Physician Fee Schedule Final Policy for Calendar Year 2018

On November 2, CMS issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2018. The overall update to payments under the PFS based on the finalized CY 2018 rates will be +0.41 percent. This […]

Highlights of Quality Payment Program for Year 2 (Calendar Year 2018) Under MACRA

Here are the highlights of the Final Rule for QPP for Year 2 under MACRA as announced by CMS yesterday: • Weighting the MIPS Cost performance category to 10% of your total MIPS final score, and the Quality performance category to 50%. • Raising the MIPS performance threshold to 15 points in Year 2 (from […]

EMRs Taking Away Close to One-Third of Physicians’ Work Time – AMA

The EMR Time Crunch A common complaint among physicians across practices and specialties has been the amount of time that was previously spent attending to patients is now being occupied by clinical documentation.  These time disparities can have adverse effects on physician-patient relationships, and also limit the number of patients able to receive care from […]

The Prevalence and Consequences of Medical Errors in American Medicine

Part I There are numerous records that we maintain, or are maintained on us, over the course of our lives.  Our school records track our grades and accolades. Our public records track our civic life and criminality. Our resumes document our accomplishments and abilities.  And our medical records compile the history of our overall health […]

The Cost of Care: How AI is Revolutionizing Healthcare and Driving Down Prices

The cost of healthcare is once again at the center of a national debate.  With premiums rising, the baby boomers aging, and diabetes, the most expensive disease in the world, affecting 10% of the US population, the rising cost of healthcare in America is an issue that affects all of us.  In the past, the […]