HEDIS is an important yardstick by which health plans can measure their performance and worth. In fact, this yardstick is being employed by over 90% of health plans in the US. Results that come with...
Diagnostic Errors Rank High Among the Most Harmful Medical Mistakes
A new study published in the BMJ Quality & Safety Journal by a group of researchers at the Johns Hopkins University School of Medicine found diagnostic errors to be the most common and costly...
Reimbursement for Ultrasound Guided Pain Management
Healthcare providers in any medical specialty should submit claims with appropriate medical codes and modifiers to receive proper reimbursement for services provided. This holds true for the...
Guidelines for Using ‘Separate Procedure’ CPT Codes
The AMA Current Procedural Terminology (CPT) lists a term ‘Separate Procedure’ under surgery guidelines. The term refers to the procedures and services performed as integral components of a total...
Getting to Know the Provisions under ERISA
What is ERISA? ERISA is something your practice needs to know about. ERISA, or Employee Retirement Income Security Act, is a 1974-enacted Federal Law conceived to protect the pension plan of an...
Dangers of Erroneous Submission of Medicare Claims
The faulty submission of medical claims can get you into serious financial trouble and adversely impact the bottom line of your practice. A recent example is the case of the St Luke’s University...
How the 2% Medicare Reimbursement Reduction Will Affect ASCs
The debt-ceiling crisis in United States during 2011 paved way for the imposition of Budget Control Act of 2011. The measures to reduce discretionary spending kicked off in January 2013 with the...
Meeting HEDIS Quality Care Goals
There is an increasing focus on the quality of care, whether its prevention, early diagnosis of illness, or therapeutic services. HEDIS ((Healthcare Effectiveness Data and Information Set), created...
Crisp and Objective Obama Care Coverage Forms
Affordable Care Act or Obama HealthCare will provide tax credits to the low/middle-income group of Americans, thus helping them purchase insurance through state-run insurance exchanges. The coverage...