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GroupOne Health Source Practice Management Blog

 

The GroupOne RCM Blog

 

Is Your Documentation Ready for the End of the ICD-10 Grace Period?

by Kaitlyn Houseman on May 31, 2016

Clinical documentation is at the heart of every patient encounter. It needs to be meaningful, and to be meaningful, it needs to be clear, accurate and timely. Clinical documentation isn't just critical for patient care, it is also used to share critical information with other providers while optimizing the claims process. However, with implementation of ICD-10 from October 2015, provider clinical documentation became much more complex: There are now nearly 70,000 codes, up from nearly 14,000 in the ICD-9.

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Topics: Revenue Cycle Management, ICD-10, Coding

MACRA: New Opportunites for Medicare Providers with Alternative Payment Models

by Jeff Jones, CPHP on May 26, 2016

With the repeal of Medicare's sustainable growth rate formula also came the opportunity for physicians to eventually leave the traditional Medicare fee-for-service system behind. The shift from fee-for-service to value based reimbursement is a new opportunity for physicians but with it comes some challenges in understanding how it will work. The final rule, released on Oct. 14th, details how Alternative Payment Models (APM) will enhance or replace some of the current fee-for-service payments with a patient-level payment not related to volume or intensity.

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Topics: Value-Based Reimbursement, Incentive Programs, MACRA, Alternative Payment Models

What You Need to Know About the MACRA NPRM

by Jeff Jones, CPHP on May 25, 2016

The Centers for Medicare and Medicaid have released the notice of proposed rule-making (NPRM) for the Medicare Access and CHIP Reauthorization Act. The proposed rule was released in late April and the final rule is schedule to be released in the fall of this year (2016). Here is a breakdown of the MACRA NPRM if you haven't yet had the time to read the entire 962 pages.

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Topics: Revenue Cycle Management, CMS, Merit Based Incentive Payment System, Incentive Programs

[Infographic] The Impact of Nursing Leadership Styles on Patient Outcomes

by Tim Wayne on May 20, 2016

Between declining reimbursement, new incentive programs, and keeping pace with the competitive industry of healthcare, healthcare managers and leaders are in a constant struggle to become more efficient and effective. Healthcare is becoming increasingly complex, and juggling these modern day challenges while still being a good leader and providing effective care for patients can be challenging to say the least.

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Topics: Revenue Cycle Management, Medical Business, Patient Engagement

A Simple Guide to Understanding PQRS Measures and Specifications

by Jeff Jones, CPHP on May 19, 2016

In 2016, providers are able to select from a large number of measures to submit PQRS data. However, understanding PQRS measures and specifications can be overwhelming. And since the measures you choose have a large impact on your quality and cost scores, deciding on the right measures to report should not be taken lightly. Here we will guide you through how to better understand PQRS measures and the specifications for measures.

 

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Topics: PQRS, Incentive Programs

Survey of Physicians Shows Declining Satisfaction with Electronic Health Records

by Kaitlyn Houseman on May 17, 2016

A new report from AmericanEHR Partners and the American Medical Association (AMA) based on a survey of physicians, shows that compared to five years ago, more physicians are reporting being dissatisfied or very dissatisfied with their EHR system. The survey on Physician Use of EHR Systems 2014 found that close to, or more than half of all respondents, reported a negative impact in response to questions about how their EHR system improved costs, efficiency or productivity.

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Topics: EHR

Managing the Revenue Cycle: 7 Areas for Improvement

by Kaitlyn Houseman on May 12, 2016

Did you know that an underperforming revenue cycle causes US doctors to leave around $125 billion per year on the table? Being successful in the healthcare industry requires not only outstanding patient care but also an efficient revenue cycle management process. While some practices excel at both, others are struggling to develop an RCM process that is efficient and profitable.

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Topics: Revenue Cycle Management

Switching EHR Vendors? Here Are 6 Must-Have EHR Features

by Adrienne Schrimpf on May 11, 2016

Ten years ago, electronic health record (EHR) systems started gaining traction, and that was before things like Meaningful Use and PQRS motivated physicians to adopt an EHR. Back then, the government had minimal involvement in EHR adoption, and much of it was actually driven by smaller practices looking for ways to streamline processes and get a better handle on patient data. 

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Topics: EHR

Top 20 Most Popular EMR Software Solutions

by Kaitlyn Houseman on May 7, 2016

EHR systems assist medical practitioners in the creation, storage, and organization of electronic medical records, including patient charts, electronic prescriptions, lab orders, and evaluations (just to name a few common features). But what is the most popular electronic health records (EHR) software?

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Topics: EHR, Practice Management, EHR Training

The Value-Based Payment Modifier Program and It's Impact on Your Practice

by Jeff Jones, CPHP on May 4, 2016

The Value-based Modifier (VBM) provides for differential payments to a physician or group of physicians under the Medicare Physician Fee Schedule and is based upon the quality of care furnished compared to cost during a performance period. The Value Modifier program will provide comparative performance information to physicians as part of Medicare’s effort to improve the quality and efficiency of medical care. Here is how the Value Modifier program relates to PQRS and MIPS to further the movement from fee-for-service to value-based reimbursement.

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Topics: PQRS, Value-Based Reimbursement, Incentive Programs

Selecting the Right PQRS Measures: Individual vs. Measures Groups

by Jeff Jones, CPHP on May 2, 2016

Taking time to select the right PQRS measures can make a huge difference in an Eligible Providers (EP) performance in PQRS. How? Because choosing PQRS measures that align with your specialty usually makes it easier to report for the PQRS. Therefore the measure selection process should begin with a review of the entire measure list to determine which measures are important to the EP and the practice.

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Topics: PQRS, Incentive Programs

5 Ways to Increase Physician Referrals to Your Practice

by Kaitlyn Houseman on April 28, 2016

Independently owned clinics - particularly specialty clinics - may find the process of getting physician referrals to be daunting. There are multiple reasons for this. For one thing, the number of specialist categories has grown in the past decade, so there are more types of specialists for patients to be sent to. At the same time, there are more multispecialty groups that refer to specialists within the group, while many smaller clinics are being purchased by hospitals where internal referrals dominate.

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Topics: Revenue Cycle Management, Medical Business, Practice Management

What Is the Patient Experience?

by Kaitlyn Houseman on April 26, 2016

The concept of "patient experience" seems straightforward however, there are widely varying views among people in the healthcare industry as to what the "patient experience" really means. Nearly three-quarters of respondents (74%) to the  2013 HealthLeaders Media Patient Experience Leadership Survey expect to focus on patient experience training and education over the next three years. The patient experience is clearly a priority but what is it?

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Topics: Practice Management, Patient Engagement

How to Prepare for Thousands of New ICD-10 Codes

by Kaitlyn Houseman on April 19, 2016

The shift from ICD-9 to ICD-10 brought some big challenges to healthcare. To help relieve some of these transition difficulties, the CDC and CMS instituted a freeze on updates to the codes prior to the October 1, 2015 implementation date, according to the American Hospital Association. But now, CMS has lifted the freeze and announced they will be adding a host of new diagnostic and hospital inpatient procedure codes (5,000+ new codes) to ICD-10 for fiscal year 2017.

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Topics: Revenue Cycle Management, ICD-10

How to Avoid Revenue Loss During Your EHR Transition

by Keith Lage on April 18, 2016

An upgrade or change of vendor for an electronic health records (EHR) system is a major IT initiative, and disruption is to be expected. The problem is that a hiccup in one business process can propagate causing disruption to your entire practice, or in this case, your practice's revenue cycle management.

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Topics: EHR, EHR Training

Everything You Need to Know About PQRS Reporting Methods

by Jeff Jones, CPHP on April 15, 2016

As we shift the focus from volume and profitability to patient outcomes, physicians are having to dig a litter deeper into reporting. Healthcare is shifting towards value-based reimbursement models and the Physician Quality Reporting System (PQRS) is a step in that direction. Unfortunately, at first glance, PQRS and CQM programs can be intimidating to say the least. Not only can PQRS be intimidating, but a large number of physicians believe that PQRS is time-consuming. PQRS participation rates reflect the number of providers that aren't making PQRS a priority. 

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Topics: PQRS, Incentive Programs

Understanding PQRS: What It Is and What You Need to Know Now

by Jeff Jones, CPHP on April 12, 2016

You could say Meaningful Use stole the spotlight from PQRS over the past couple of years. This could be why so many providers still have questions about the Physician Quality Reporting System. With the Merit Based Incentive Payment System (MIPS) just around the corner, PQRS isn't quite in the spotlight but it does play an important role in physician reimbursement. Now is the time to begin understanding PQRS (if you don't already) and how it will contribute to MIPS.

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Topics: PQRS, Incentive Programs

CMS Launches Comprehensive Primary Care Plus: Value-Based Model for Primary Care Practices, Multiple Insurers

by Kaitlyn Houseman on April 11, 2016

The Centers for Medicare and Medicaid Services on Monday launched a new risk-based primary care initiative that it hopes will accelerate the movement towards value-based reimbursement for medical practices. The five-year, Comprehensive Primary Care Plus, or CPC+, starts in January 2017 and will include up to 5,000 practices and 20,000 physicians in an estimated 20 regions.

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Topics: Value-Based Reimbursement, Incentive Programs

Communicating About Co-Pays to Patients

by Kaitlyn Houseman on April 11, 2016

Increasing plan deductibles might be a sound solution to slowing health care cost growth, but these high deductible health plans pose a new array of challenges to healthcare revenue cycle management. The number of people covered by an employer-sponsored high-deductible health plan (HDHP) is growing while almost 90% of enrollees in Affordable Care Act (ACA) in Affordable Care Act (ACA) Marketplaces have a HDHP. Communicating financial responsibilities to your patients is no longer optional, it's essential.

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Topics: Revenue Cycle Management, Practice Management

Common EHR Myths Debunked

by Adrienne Schrimpf on April 7, 2016

EHRs have come a long way in the past couple of years. We've seen vendors exit the market while others have gained market share and in the cloud has become a common theme. Of course we're all counting down to the day when interoperability is solved and we can easily communicate patient information regardless of organizational, geographic, or vendor boundaries. In the mean time, I want to put an end to some common EHR myths I encounter during the sales process.

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Topics: EHR

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