NantHealth LLC, a next generation, evidence-based, healthcare company based in California, continues to market its molecular profile test, GPS Cancer. As a result, the molecular profile test is now getting coverage from self-insured employers such as Bank of America, Sanford Health and Phoenix Children’s Hospital. NantHealth, who also acquired Navinet in January 2016, recently launched Navinet Open Claims Management Application Suite. Read on about NantHealth and their advancements in cancer care management at the NantHealth Website: http://nanthealth.com
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How to Reduce Risk When Implementing an EHR System
Electronic health records (EHRs), or electronic medical records (EMRs), are quickly becoming the industry standard when it comes to charting patient visits, including symptoms, test results, diagnoses, treatments, notes, and any other pertinent information that used to go into paper records. There are a lot more benefits to these digital systems than merely the speed of typing in information rather than writing it by hand. The use of electronic medical records software has revolutionized the way patient information is entered, stored, and shared, increasing efficiency not just in the office or hospital setting, but on an industry-wide scale. Plus, the…
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CMS Clarification of 60-Day Reporting Requirements: Medicare Parts A & B
Prior to the February 12, 2016 Final Rule, many were confused about verbiage of the 60-day overpayment reporting requirements. When does the 60-day reporting period begin and what does it mean to have “identified” an overpayment? The Final rule, effective March 14, 2016, answers these questions along with specifying a 6-year loopback term. Read Full Article Published by: Williams Mullen, By: Patrick C. Devine, Jr., Matthew M. Cobb & Ruth Levy: April 6, 2016
New Medicare Penalty Hits Small Groups and Solo Physicians the Hardest!
Medicare has proposed a new compensation formula that will “bonus” approximately 400,000 physicians (and other clinicians) in 2019. Unfortunately, this proposed formula will also likely result in penalties for around 350,000 Physicians and clinicians mostly in practices from one to 24 members. The April 27th proposal, more than 900 pages long, outlines a gradual shift of reimbursements from fee-for-service to pay-for-performance or Pay-for-value. To read the full Medscape Article: Click Here Published by: Medscape Medical News: Robert Lowes, April 28, 2016:
Common Challenges Training Your Staff to Use New EHR Systems
Electronic Health Records (EHRs), also known as electronic medical records (EMRs), are basically just digital versions of the paper medical records used to chart a patient’s medical history. More and more, these virtual records are supplanting traditional files due to greater efficiency, ease of use, and extras like the ability to allow access to information. This, in turn, lets medical professionals securely share patient files with one another, while patients can also gain access to their own medical history as a means of remaining informed and making better decisions about their own healthcare. In other words, there’s a lot to…
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Health Systems Cyberattacks Increase. Is Your Patient Data at Risk?
Recent high-profile cyberattacks on health systems and health insurance companies are a topic of discussion in this alarming article published by Williams Mullen. Is your patient data at risk? Read the Article Published by: Williams Mullen: Robert Van Arnam, Patrick C. Devine, Jr., & Kelsey S. Farbotko: March 23, 2016
Drug Pricing Lawsuit between Anthem/Express Scripts Totals $15 Billion
Anthem has sued Express Scripts Holding Co. for $15 billion in damages alleging that Express Scripts is not passing along billions of dollars in savings from negotiated drug pricing. Anthem is also suing for $150 Million for “Compensation related to operational breaches”. Read full Article Published by: Modern Healthcare: Bob Herman, March 21, 2016
5 Ways You Can Prevent Medical Billing Mistakes
Providing health care can be a complicated and difficult practice in many ways. The idea of operating any business is to make a profit, and your business will, of course, not be able to stay afloat if you don’t. But then, the reason you likely got into health care to begin with is not to make money but rather to help people. Everyone is going to need medical attention at some point, and unless they are willing to get their procedure done in a shady back-alley, they will have to pay for it. So it is your responsibility to make…
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Outsourcing Your Medical Billing: 5 Factors to Consider First
When you run a medical practice, you have a lot to occupy your mind, mainly when it comes to the ongoing health and wellness of your patients. The last thing you want to have to deal with after a long day of treating patients and filling out charts is billing. Unfortunately, if you don’t deal with medical billing and coding, you’re not going to get paid. Don’t fret – there are professionals trained for this very purpose. You just have to decide if you want to hire a specialist for your staff or if outsourcing is a better option. Here…
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Private Medicare Insurers Face $13 Million in Medicare Fines
Has your practice received a letter from Private Medicare insurers? Do they regard your Medicare Advantage and Part D plan participation and the CMS compliance requirements they are now enforcing? These letters, which outline a long list of compliance measures that must be met to maintain PAR status, started going out to Providers in Q4 of 2015. The following Modern Healthcare article does a great job explaining why the insurers are cracking down and requiring proof of CMS compliance from providers that offer these Federal plans. Read Full Article Published by: Modern Healthcare: Bob Herman March 7, 2016