Posted and filed under Business, Healthcare, Payers.

Value-Based Purchasing Still Perplexing Providers

Providers are still struggling to align with payers in the transition to value-based purchasing. Value-based purchasing is used to measure, report, and reward excellence in health care delivery. To properly incentivize high-quality care, value-based purchasing requires the cooperation of employer purchasers, public sector purchasers, health plans, and providers who are all tasked with assessing care…

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Posted and filed under Compliance, Cybersecurity, Healthcare.

HITRUST FAQ

Q: Just what is HITRUST anyway? A: HITRUST is a common security framework (CSF) created and governed by the HITRUST Alliance, a privately held U.S. company made up of leaders from healthcare, technology, and information security. The framework is comprised of several prescriptive security controls that can be assessed to determine the level of information…

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Posted and filed under Fraud, Healthcare.

Bad Reputation: Big Pharma’s Eventful Year

Thinking back to late 2015, the pharmaceutical industry was shaken by a tsunami of criticism and vitriol, all thanks to the rapacity of Big Pharma “bad boy” Martin Shkreli. You may recall Shkreli’s ill-received decision to jack up the price of Daraprim from $13.50 a pill, to an inconceivable $750 per pill only one month…

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Posted and filed under Dental, Healthcare.

Our Oral Health is Determined by Our Zip Code

If you were ever subjected to the unsavory fluoride treatments at the dentist as a child, you’re probably one of many who are relieved to be receiving the same dental benefits in a manner that doesn’t assault your taste buds!  Now that fluoridated water is circulating through about 75% of public water lines, the population…

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Posted and filed under Dental, Healthcare.

Are you Tired of the Sales Pitch From Your Dentist?

Many times when going into a dentist appointment recently, dentists are always trying to sell add on dental products to the patient. Even when going in for a simple routine visit, your appointment turns into a pressured sales pitch! The add-on dental products to expect include: In office bleaching Take home bleaching 1000 different paste (Sensitivity, whitening, fluoride…) Rinses…

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Posted and filed under Healthcare.

Top Oral Cancer Indicators

Oral Cancer is a growth or sore in the mouth that does not go away. Oral Cancer can be life threatening if not diagnosed or treated early. According to the American Cancer Society, men face twice the risk of developing cancer as women. Men who are over 50 face the greatest risk. It is estimated…

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Posted and filed under Coding, Healthcare, ICD-10.

Why Are Medical Professionals Panicking?

This is an actual experience from one of our Advize Health employees. This morning I went to the doctor’s office and the entire mood of the office was different. The staff including the nurses, doctors, and PA’s was panicking and many of them appeared to be upset. Why is this?  It is October 2, 2015,…

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Posted and filed under Coding, Healthcare.

Clearing Up Some Eye Exam Confusion

How are eye exam codes defined? CPT includes four codes that specifically describe eye exams: 92002:  Medical exam and evaluation with initiation of diagnostic and treatment program; intermediate, new patient. 92004:  Medical exam and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, one or more visits. 92012:  Medical exam and evaluation with…

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Posted and filed under Compliance, Healthcare.

What to Watch Out For With Credit Balance

In May 2014, the Department of Health and Human Services, Office of Inspector General (OIG) published a proposed rule updating its regulations. The proposed rule will authorize civil monetary penalties for “failure to report and return a known overpayment,” among other issues.   The rule has outlined the penalty for failure to report and return overpayments…

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Posted and filed under Healthcare.

What is the Underlying Cause of Tooth Decay?

Our diet! Tooth decay results from the acid produced when sugar and oral bacteria in the mouth combine and feed off each other. Frequently consuming foods higher in acid content can lead to irreversible dental erosion.  Dental erosion is the breakdown of the tooth’s structure; the outer layer called enamel.  Dental enamel is the thin…

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