#AAPC

Nov 4, 2019

Facebook Launches Platform to Promote Preventive Care Access

Amazon, Walmart, Uber, Lyft, Google, now Facebook...noticing a trend yet? The giants are flooding into healthcare, which means major industry disruption is coming! Facebook's new preventive health functionality tool will remind you about when to schedule well exams, screenings, vaccines, etc. This tool serves as your preventive medicine to-do list, but in digital form. It will be interesting to see if Facebook has worked out the kinks on third-party data access, securit

Strategies to reduce patient billing disputes

Alpha Coding Experts

Nov 1, 2019

Strategies to reduce patient billing disputes

In the age of information, consumers want to make informed decisions prior to purchase, and this most definitely includes healthcare decisions. For many years, consumers have been hit with surprise medical bills. It almost feels like a game of Gotcha! If you get an MRI from XYZ facility it costs $250, but if you go to XYZ facility 3 blocks down the street, the same service costs $1200. Price transparency is a small step in the right direction, but a lot more work needs to

Walmart Health innovates integrated care

Alpha Coding Experts

Oct 31, 2019

Walmart Health innovates integrated care

Walmart Health's integrated care and flat fee approach could serve as a model for the healthcare industry. Based on Walmart Health's one-stop-shop approach, patients have access to primary care, behavioral health, dental care, vision, health education and wellness programs, all in one place. Comprehensive care is a concept providers and health systems have long struggled to capture and implement successfully. Will Walmart's innovative approach be successful and sustainable

Uber and Cerner form strategic partnership

Alpha Coding Experts

Oct 30, 2019

Uber and Cerner form strategic partnership

Uber and Cerner have announced a partnership that integrates ordering nonemergency medical transportation (NEMT) services from Uber Health directly through Cerner's EHR platform. This partnership empowers providers, hospitals, and health systems with more resources to address barriers to accessing care. The social determinants of health (SDOH) diagnosis codes play a vital role in justifying medical necessity for these nonemergency medical transportation services. #MedicalCod

Fraud and Abuse practices linked to mortality

Alpha Coding Experts

Oct 29, 2019

Fraud and Abuse practices linked to mortality

Fraud, waste, and abuse in our healthcare system is rampant. It is estimated that between $30 to $140 billion dollars represent fraudulent medical practices annually. These concerns have long been scrutinized from a financial standpoint, but new studies suggest it also represents a major public health threat to patients. #MedicalCoding #MedicalBilling #Compliance #Revenue #RevenueCycle #RevenueCycleManagement #AlphaCodingExperts #AAPC #AHIMA #Coders #Auditors #Physicians #H

Will Amazon revolutionize care navigation like eCommerce?

Alpha Coding Experts

Oct 28, 2019

Will Amazon revolutionize care navigation like eCommerce?

A future with Amazon at the epicenter of healthcare is getting closer and closer as they continue to expand their market share. Amazon is a central part of our daily lives. Imagine a world where you ordered your next annual visit or mammogram the same way you order groceries or a box of diapers? How will consumer reviews influence patient decision-making and referrals? Will Amazon revolutionize care navigation the way it has with eCommerce? #MedicalCoding #MedicalBilling

Alpha Coding Experts

Oct 25, 2019

Healthcare is getting a Lyft

We have seen the transportation industry rapidly transform in just 5 short years. Lyft made history this summer by landing the first state Medicaid contract with Arizona's Medicaid program for ride-sharing services in the country. And Lyft just landed 5 new state Medicaid Contracts with Georgia, Michigan, Tennessee, Virginia, and Misssouri. Lyft's reach will continue to expand as the demand for these services explodes. The social determinants of health (SDOH) diagnosis c

Alpha Coding Experts

Oct 24, 2019

Are MAC policies enforceable?

Ever wondered how much clout your Medicare Administrative Contractor (MAC) actually has? I get this question A LOT: My MAC doesn't have an established policy on XYZ issue, but another MAC does - can I use it? The answer is yes and no. David's article does an incredible job of providing real-world legal insight to this question. However, when it is all said and done, a MAC policy does not have the same effect as a regulation or statute. It is simply a starting point. #M

Alpha Coding Experts

Oct 23, 2019

Accountability for Medicare Advantage

Nearly 1 in 3 Medicare patients are enrolled in a Medicare Advantage plan. These plans are often administered by private insurance companies. Risk adjustment data validation (RADV) audits reveal that billions of dollars are fraudulently billed by Medicare Advantage health plans each year. These upcoding practices are so rampant that Kaiser Health News is suing Centers for Medicare & Medicaid Services (CMS) for the audit results that support these claims. CMS officials sta

Alpha Coding Experts

Oct 22, 2019

Are coding audits worth the investment?

Conducting regular coding audits and education are essential components to a healthy compliance program. Coding audits are hands down one of the best investments any practice, hospital, or health system can make. The return on investment (ROI) is infinite. And with ADRs, payer audits, and RAC audits on the rise, you simply cannot afford to ignore this area any longer. I am shocked by how many professionals remain unaware that regular audits are mandated by the Patient Pro

Alpha Coding Experts

Oct 21, 2019

AAPC or AHIMA?

I am routinely asked which coding certification is more valuable: AAPC or AHIMA? The answer to this question is highly personal and contingent on your long-term career goals. Both organizations (AAPC and AHIMA) are the gold standard for the medical coding profession. Historically, AAPC has served the outpatient side of medicine and AHIMA has served the inpatient side. However, in recent years we have seen both organizations make strides to appeal to both outpatient and i

Alpha Coding Experts

Oct 18, 2019

EQ is Your Best Investment

Emotional Intelligence (EQ) is one of the most sought after skills in today's job market. EQ is your ability to purposefully understand, manage, and navigate your emotions and the emotions of others around you. Hiring Managers and C-Suite Executives often state EQ is much more valuable than IQ. Investing in your EQ will pay substantial dividends over time! #MedicalCoding #MedicalBilling #Compliance #Revenue #RevenueCycle #RevenueCycleManagement #AlphaCodingExperts #AAPC #A

Alpha Coding Experts

Oct 17, 2019

8 strategies to promote successful CDM

Claims denial management (CDM) is the hot topic of every healthcare organization. How can we send cleaner claims, reduce denials, decrease days in A/R, and work more efficiently? Through a rigorous internal audit, root causes to your most complex issues can be identified. Below are 8 strategies to promote a more efficient CDM process. #MedicalCoding #MedicalBilling #Compliance #Revenue #RevenueCycle #RevenueCycleManagement #AlphaCodingExperts #AAPC #AHIMA #Coders #Physici

Alpha Coding Experts

Oct 16, 2019

Official Election Results

Alpha Coding Experts is proud to announce that our CEO, Toni Elhoms, was elected as the 2020 AAPC Orlando Chapter Secretary. As Toni states: "This is a huge honor and I am proud to serve our membership alongside my fellow board members. With over 1200+ members, the Orlando Chapter is one of the largest AAPC Chapters in the United States. 2020 is going to be an epic year for our members! Thank you again for this opportunity." For more information about the Orlando AAPC Cha

EHRs Continue to Contribute to Medical Malpractice Suits

Alpha Coding Experts

Oct 15, 2019

EHRs Continue to Contribute to Medical Malpractice Suits

EHR systems without proper oversight create many systemic problems for organizations and specifically providers. Errors in medical record documentation can surface in medical malpractice suits such as the instances detailed in Terry's article. The DOJ continues to put EHR systems on high alert regarding violations of the False Claims Act (FCA), meaningful use, copy forward functionality, etc. EHR systems can be great tools, but must be used with caution! #MedicalCoding #Med

Alpha Coding Experts

Oct 11, 2019

Payers to have direct access to EHRs

Payers are advocating for direct access to EHR systems in an effort to streamline medical record data and aggregation. Payers believe this will expedite claims processing, pre-payment reviews, audits, etc. It will be interesting to see how the provider community at large responds to this campaign. #MedicalCoding #MedicalBilling #Compliance #Revenue #Payers #RevenueCycleManagement #AlphaCodingExperts #AAPC #AHIMA #Coders #HIM #EHR #BigData #IG Payer Access to EHRs: What Prov

Will History repeat itself with ICD-11 on the horizon?

Alpha Coding Experts

Oct 10, 2019

Will History repeat itself with ICD-11 on the horizon?

With ICD-11 slated to take effect on January 1, 2022, it is hard to imagine adoption of a brand new code set considering ICD-10 was implemented only 5 years ago. The time, money, resources, acts of congress, sleepless nights, and headaches it took to get to ICD-10 implementation day is something I don't think anyone working in the industry will ever forget. Many subscribed to the ICD-10 apocalypse. Will ICD-11 implementation be more of the same? #MedicalCoding #MedicalBillin

Who needs code books or encoders? We just Google It!

Alpha Coding Experts

Oct 9, 2019

Who needs code books or encoders? We just Google It!

I have heard this countless times over my professional career: "We can't afford to update code books or encoders so we just google the codes". This is a disturbing sentiment especially in the era of ADRs, compliance audits, pre-payment review status, recoupments, and increasingly sophisticated data analytics. Utilizing up-to-date coding and authoritative resources is non-negotiable! Terry's insights about the compliance risks associated with using the internet to code a

Six Strategies to improve outpatient coding

Alpha Coding Experts

Oct 4, 2019

Six Strategies to improve outpatient coding

As health systems and hospitals continue to acquire physician practices, the quality and accuracy of outpatient coding becomes increasingly more important. The days of lackadaisical enforcement are over! These strategies will help you make documentation audit-proof. #MedicalCoding #MedicalBilling #Compliance #Audit #AHIMA #AAPC #RevenueCycleManagement #Revenue #RevenueIntegrity #AlphaCodingExperts By Keith Olenik, MA, RHIA, CHP Originally posted on AHIMA As healthcare servi

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