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October 01, 2017

Keeping current on CPT

A recent announcement by Elsevier and the American Medical Association (AMA) reflected not only our ongoing commitment to helping healthcare organizations keep up in a rapidly changing industry, but also the value of online learning in such an environment.

On August 7, the two organizations stated their intention to co-develop eLearning...

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July 25, 2017

A Plug for Stopping Revenue Cycle Leaks

It’s called a revenue CYCLE for a reason, as the process isn’t done until the circle is complete. Unfortunately, in this instance, there are numerous points along the way that can spin that process off course.

That’s why we’re hearing a lot of talk these days about “revenue cycle...

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June 09, 2017

Don’t take chances with risk adjustment

June 9, 2017

As noted by Healthcare Financial Management late last year: “A health system’s financial success under payment contracts that include some sort of risk adjustment depends largely on the extent that its physicians can accurately and completely document and code their patients’ conditions and treatments.”

Risk adjustment is...

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May 17, 2017

A cheat sheet for coding mom-related ailments

May 12th, 2017

As education purveyors, we know it always helps to break massive tasks (such as coding in ICD-10) down to workable chunks. You know, most used codes, codes specific to a discipline, codes with the most potential impact on compliance and revenue, etc.

In honor of that premise...

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May 05, 2017

Adding fuel to the fire of revenue collection

May 5th, 2017

Earlier this month, we talked about the impact of high health insurance deductibles on revenue collection and the importance of training staff to handle sensitive financial conversations with patients.

In a recent article, “15 things to know about hospital billing and patient payments,” Becker’s Hospital...

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April 06, 2017

Making financial conversations less painful & more productive

April 6th, 2017

As insurance deductibles continue to rise, so does the impact on consumers, leaving more and more patients responsible for greater portions of their healthcare costs. This situation puts pressure not only on consumers, but also on hospitals, which now are struggling to collect those patients’...

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March 17, 2017

Happy belated Digital Learning Day

March 17th, 2017

February 23 has come and gone, but online education continues to gain ground daily, according to various surveys and anecdotal evidence.

Part of the reason for its ascendance likely can be found in our increasingly tech-savvy society, in which individuals already happily stare at, and interact on, electronic devices...

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March 01, 2017

MACRA: A Glass One-Third Full

March 1st, 2017

In a recent Health Catalyst®/Peer60 survey, only 35 percent of the healthcare executives polled said their organization has a MACRA (Medicare Access and CHIP Reauthorization Act) implementation strategy and are prepared for the new value-based reimbursement model.

As explained in the survey report, MACRA consolidates and replaces a...

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February 17, 2017

High-Deductibles and Maximizing Revenue

February 17th, 2017

In a recent blog we announced the forthcoming addition of Healthcare Financial Management Association (HFMA) courses to the slate of eLearning available through the Elsevier performance management platform.

This week, we’d like to focus in on one of the curricula – Patient Financial Communications – which presents best practices...

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February 03, 2017

2017 Brings In Considerations of Outpatient CDI

February 3rd, 2017

As recently reported by the Advance Healthcare Network, a white paper published by the Association of Clinical Documentation Improvement Specialists (ACDIS) shows that only about 10 percent of hospitals currently have an outpatient CDI program.

At least, those were the results of a survey...

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January 20, 2017

A Focus on RCM: A Sure Bet in an Uncertain World

January 20th, 2017

On December 20, 2016, Black Book Market Research released the results of a survey on healthcare tech trends for the New Year.

Among the nine listed was this: “Middle office functions such as coding and clinical documentation improvement initiatives will be recognized...

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January 03, 2017

A macro view of MACRA

December 14th, 2016

In our last blog about coding concerns in the New Year, we listed the new Quality Payment Program, noting that 50 percent of physicians say they are in the dark as to its meaning and ramifications on documentation, coding and reimbursement. Having raised the issue, we thought it...

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December 30, 2016

Looking ahead: coding concerns in 2017

November 30th, 2016

Now that we have officially entered the holiday season, it’s natural to start thinking ahead to the New Year and what 2017 will bring. Even though on the calendar the ICD-10 transition is long gone, it’s to be expected that medical organizations and practices will still likely...

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November 16, 2016

New coding guideline contradicts quality program auditing policies

November 16th, 2016

The Workgroup for Electronic Data Interchange (WEDI) has released an issue brief on clinical documentation and the 2017 ICD-10 Official Guidelines. According to WEDI, the new coding guideline conflicts with reporting and auditing policies for several quality programs, as well as medical necessity rules and...

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October 26, 2016

It’s a wrap – Post AHIMA 2016

October 26th, 2016

We’re back from AHIMA 2016, and what a great conference it was again this year. AHIMA, you never disappoint! Great information regarding the emergence of “Big Data” and its impact in the healthcare world was shared, and we were very impressed with the conference’s lineup of...

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October 05, 2016

A hard look at ICD-10 specificity

October 5th, 2016

In our previous blog, we posed a series of questions that AHIMA convention goers might wish to consider while at the event. They included: “Is my organization’s ICD-10 coding consistently accurate?”

In retrospect, we should have added: “Have we achieved the specificity required?”

That’s because, as CMS has advised,...

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September 22, 2016

Are you ready for AHIMA 2016?

September 22nd, 2016

This year’s AHIMA Convention in Baltimore, MD takes on the issues surrounding the massive amounts of data available today, looking at how it can and should be governed for healthcare purposes and its role in shaping the industry’s future.

A behemoth that grows daily, so-called “Big Data”...

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September 22, 2016

We’re not off the hook anymore: The ICD-10 grace period comes to a close October 1

September 7th, 2016

Remember when Y2K was approaching, and everyone was in a complete panic about what the unknown abyss of change was going to do with basically every computer system in the world? And then January 1, 2000 came...

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August 24, 2016

The 2016 Rio Olympics: Decoded

August 24th, 2016

This year’s Olympics in Rio have been nothing short of a wild ride – a nail biting roller coaster, for that matter – with the kind of excitement we all come to anticipate from the games. But when you have world-class athletes performing mind-bending feats of strength and...

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July 27, 2016

New rules gives providers and employers improved access to information for better patient care

July 27th, 2016

If there weren’t already enough pressing reasons for accurate and precise documenting and coding in the healthcare world, now enter MACRA. The Medicare Access and CHIP Reauthorization Act, known as MACRA, is the next generation of healthcare legislation. In...

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July 13, 2016

The shift to value-based care: Technology will be key

July 13th, 2016

The healthcare industry is always changing, but there’s been a lot of attention on one major impending evolution in particular – the move from volume (or fee-for-service) to value-based (outcome) payment models. This new wave of the future is something that all healthcare organizations...

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June 29, 2016

Home Health Care programs under scrutiny by the Office of the Inspector General

June 29th, 2016

Now is the Time to Improve Your Home Health Coding & Documentation

Home Health has long been recognized as a program area vulnerable to fraud, waste and abuse, but now the Office of the Inspector General (OIG) has made it clear...

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June 16, 2016

Training at your station

June 16th, 2016

As noted recently on, multiple mandates of healthcare reform make it imperative that hospitals “have an effective revenue cycle management system in place so they can handle the financial pressures that come from regulation.”

Still, according to the article, not all are prepared. Reasons include a lack of...

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June 02, 2016

CMS announces new excluded ICD-9-CM and ICD-10-CM diagnosis codes

June 2nd, 2016

The Centers for Medicare and Medicaid Services (CMS) released an alert last week regarding newly excluded ICD diagnosis codes. According to the statement, diagnosis code 999.9 (other and unspecified complications of medical care, not elsewhere classified) will be added to the list of...

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June 02, 2016

CMS announces new excluded ICD-9-CM and ICD-10-CM diagnosis codes

May 18th, 2016

The Centers for Medicare and Medicaid Services (CMS) released an alert last week regarding newly excluded ICD diagnosis codes. According to the statement, diagnosis code 999.9 (other and unspecified complications of medical care, not elsewhere classified) will be added to the list of...

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May 04, 2016

HIPAA violations result in $2.2 million settlement

May 4th, 2016

With the complexity and ever-changing nature of healthcare regulations these days, staying on top of the constant changes in, and expansion of, rules and mandates can seem like an overwhelming task. But it’s a critical one for any healthcare organization. Violations of these regulations can have...

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April 28, 2016

Changes are coming for ICD-10-CM/PCS for FY 2017

April 28th, 2017

The numbers have been released and they are impressive. Due to a code freeze for several years and the continued need for new or revised codes, there will be thousands of code changes for FY 2017.

On March 22, 2016 the Centers for Disease Control and...

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April 28, 2016

EduCode Home Health Coding curriculum

April 28th, 2016

We are pleased to announce that soon Elsevier will be releasing a complete library of Home Health coding education. The Home Health Coding curriculum rounds out the complete Elsevier solution for Home Health which includes clinical and administrative education and tools. The EduCode Home Health Coding curriculum provides...

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