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Denial Tracking

With Grace Period Over, Denial Tracking Is the Answer

On Oct. 1, you lost the ICD-10 reporting grace period that the Centers for Medicare and Medicaid Services (CMS) granted to help ease you into complying with the new diagnosis coding system. So, why should you care? For the past year, you’ve been receiving payments for claims that were coded close to the target.  All […]
Published Date: October 18, 2016
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MACRA Final Rule

MACRA Final Rule Dissection – What it Really Means to You

Oct. 17, 2016 — On Friday, Oct. 14, the Centers for Medicare and Medicaid Services (CMS) announced the final reporting requirements for its new MACRA rule going into effect Jan. 2017. This new program is about to turn how you are paid completely upside down.   Based on MACRA, your Medicare reimbursement will be increased or […]
Published Date: October 17, 2016
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CMS Releases Final MACRA Rule

CMS Releases Final MACRA Rule, Better Defines First Year Options

Oct. 14, 2016 — There can be no more speculation as to whether the Centers for Medicare and Medicaid Services (CMS) will go live with its Medicare Access and CHIP Reauthorization Act (MACRA) regulations on Jan. 1. Earlier today, CMS released the final MACRA rule after considering more than 4,000 comments and having 100,000 attendees […]
Published Date: October 14, 2016
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MACRA Rule Changes

Physicians in Congress Call for Significant MACRA Rule Changes

The Medicare Access and CHIP Reauthorization Act (MACRA) could transform healthcare, but if the Centers for Medicare and Medicaid Services (CMS) doesn’t follow congressional intent with its regulations, compliance could become even more complicated than the current system. This is according to 18 congressional members in a recent letter to CMS Acting Administrator Andrew Slavitt […]
Published Date: October 13, 2016
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MACRA Compliance MIPS Eligibility

MACRA Compliance Step 1: Check Your MIPS Eligibility

Get ready — MACRA is definitely going live Jan. 1, and will most certainly have a huge impact on your claims payments. Before you jump on the MACRA bandwagon, you need to make sure that the program really applies to you. The Centers for Medicare and Medicaid Services (CMS) recently announced that it would release […]
Published Date: October 11, 2016
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Medicare Payment Rate

Medicare Releases Your 2017 Payment Rate Based on PQRS and QRUR Data

On Sept. 26, the Centers for Medicare and Medicaid Services (CMS) made available for download your 2015 Physician Quality Reporting System (PQRS) Feedback Reports and 2015 Annual Quality and Resource Use Reports (QRUR). These reports lay out your positive, neutral or negative payment adjustments under the PQRS and Value-Based Modifier programs, respectively, for your 2017 […]
Published Date: September 27, 2016
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ICD-10-CM Code

Laterality Frequently Unlocks ICD-10-CM Code Accuracy

To get your claims reimbursed, payers demand that you be as specific as possible with your ICD-10-CM code assignment. Often this means you must identify laterality and accurately adjust your coding to avoid claim denials and payer audits. When CMS implemented ICD-10, the number of diagnosis codes went from 14,000 to 68,000 — a massive jump. […]
Published Date: September 20, 2016
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MACRA Compliance

CMS Offers 4 Options for First Year MACRA Compliance

UPDATE: In response to CMS Acting Administrator Andy Slavitt’s Sept. 8 announcement that the agency would not delay MACRA implementation, leaders of the U.S. House Energy and Commerce Committee and Ways and Means Committee issued a statement Sept. 9 indicating that they were pleased that CMS was moving forward with options for compliance with the […]
Published Date: September 9, 2016
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60-Day Rule Timeline

Avoid Tripping Over the 60-Day Rule Timeline … Know When to Start the Clock

The relatively new 60-Day Rule affects all Medicare and Medicaid providers regardless of specialty, size or type, and nailing down the exact date to begin your 60-day countdown is one of the most confusing compliance aspects — although other rule components can easily trip you up as well. The rule may seem straightforward — you […]
Published Date: September 6, 2016
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