Understanding the Many Coding Changes Related to the FY18 IPPS
What are the big coding changes for the FY18 inpatient prospective payment system?
The Top 5 Drivers of Missing Charges
Staff engaged in revenue integrity and charge audits should carefully monitor five key categories that are most common reasons for missing charges.
ICD-10 Denials and Payment: Understanding the Relationship
Proactive, established processes to prevent denials and better manage appeals minimizes citation risks while promoting optimal, timely payment and compliance.
Sidebar: Top 10 Most Over-Documented HCCs
Documentation of chronic conditions is increasingly important as hospitals move toward value-based payment models.
Sidebar: Top 10 Most Under-Documented HCCs
Documentation of chronic conditions is increasingly important as hospitals move toward value-based payment models.
the role of HCCs in a value-based payment system
Documentation of chronic conditions is increasingly important as hospitals move toward value-based payment models.
Opioid Pattern Variations Highlight Need for Careful ICD-10 Coding
When coders capture intent, type of use, and associated manifestations for opioid abuse cases, they assist researchers in developing statistics that drive public health decisions.
How Penn Medicine’s EHR Conversion Yielded an Integrated Revenue Integrity Department
In addition to measuring metrics at each EHR go-live stage, the budding revenue integrity structure included revenue reconciliation committees at each hospital to review department charge capture daily. Ultimately, the revenue integrity department would support the clinical areas for each of these committees long-term to ensure sustainability.
Avoiding the High Cost of High-Capture Leakage
Adoption of efficient practices, along with the implementation of a charge capture system that suits the needs of a healthcare organization, can bring significant recaptured revenue.
Moving Toward a Revenue Ecosystem
To maximize results, healthcare finance leaders should establish an integrated view of the organization’s entire revenue ecosystem, aligning across organizational strategy, payer contracting, clinical operations, and revenue cycle drivers.