The Centers for Medicare & Medicaid Services (CMS) published the CY 2018 PFS proposed rule on July 21, 2017. This proposed rule includes proposals to update payment policies, payment rates, and quality provisions for services furnished under the Medicare PFS on or after January 1, 2018. Under the PFS, payments include services provided by physicians and other practitioners in all sites of service. Some of these services include but are not limited to visits, surgical...

CMS has made available the updated ICD-10-CM and ICD-10-PCS Code lists for 2018. These codes take effect on October 1, 2017. This summary identifies the new codes added, any revised codes, and the deleted codes. The link following this summary document will provide you with the new, revised, or deleted codes by specialty. Reminder: ICD-10 requires health professionals to code to the highest degree of specificity. SUMMARY OF CHANGES IN TOTAL: NEW CODES ADDED – 360 ...

Jonathan Sharr, Senior Decision Support Analyst, Middlesex Hospital A community hospital based in Middletown, Conn., Middlesex Hospital strives to provide the safest, highest-quality healthcare, and the best experience possible for our community. Our position as the state’s first Mayo Clinic Care Network member demonstrates our commitment to improving care through innovation and collaboration. To do that, we need actionable data not just within the hospital, but also across our physician practices. Multiple disparate systems complicate the...

The proposed rule for the Physician Fee Schedule (PFS) for calendar year 2018 is scheduled to be published on July 21, 2017. Within this proposal is additional information regarding the Appropriate Use Criteria (AUC) for advanced Imaging services. Evidence-based AUC for advanced imaging will assist clinicians in selecting the imaging study that is most likely to improve health outcomes for patients based on their individual clinical presentation. CMS defined qualified Clinical Decision Support Mechanisms (CDSM) as...

L. Albert Villarin, MD, FACEP Information is critical to delivering care and dozens of decisions per day are based on the what data is available at that time. Several industries, including travel and automotive, have been years ahead of healthcare in incorporating technology to gain insight and guide decisions. When you check into a hotel, they seem to know you and your preferences, including when you last stayed with them, if you prefer a higher floor...

The 2018 proposed rule for the quality payment program (QPP) is scheduled to be published on 06/30/2017. This new program went into effect 1/1/2017 known as the transition year.  The goals of the program are to improve health outcomes of Medicare beneficiaries, spend more wisely, minimize the burden to participate and become more transparent. Below is a summary of the 2018 proposed rule related to the 4 categories included under the Merit-Based Incentive Payment System (MIPS): ...

Windsor, CT -  June 22, 2017 (GLOBE NEWSWIRE) - The Carrell Clinic, a nationally recognized orthopedic medical group, has selected Meridian Medical Management to provide revenue cycle management, robotic process automation, and its proprietary PrecisionBI analytics engine.  The Carrell Clinic is considered to be one of the preeminent orthopedic medical groups in the Southern United States.  For over 96 years, The Carrell Clinic physicians have served the Dallas, Texas medical community.  The physicians of The...

Revenues collected are the lifeblood of any healthcare organization and the efficiency of how they are processed dictate its ability to grow. With each claim, there is room for human error and data-driven, manual processes that are ripe for change. Robotic process automation (RPA) is transforming revenue cycle management, bringing it to the next, more efficient, level. In fact, McKinsey & Company found that more than one third of tasks in the healthcare industry could...

Samantha Sizemore, Director of Operations, Holston Medical Group As a 150 provider, independent multi-specialty practice, Tennessee’s Holston Medical Group (HMG) strives to improve performance measures across its 26 locations. We all need to make the most of our resources and HMG looked to analytics as a means to do just that. Being part of a successful, physician-owned Accountable Care Organization (ACO) has also increased our need for insightful data. Our organization has been working with OnePartner...

Windsor, CT - June 5, 2017 (GLOBE NEWSWIRE) – Meridian Medical Management, a leading revenue cycle management and healthcare analytics company has launched their robotic process automation (RPA) suite as part of their proprietary Revenue Acceleration Program.  The foundation for the Revenue Acceleration Program is driven by the RPA suite and PrecisionBI, Meridian’s leading healthcare analytics and clinical informatics company.  Currently, their robotic process automation suite is impacting over 350 healthcare organizations.  The automation is...