Posted and filed under Coding, Healthcare.

History of Present Illness: Severity

Severity is a statement or a rating of intensity (0-10) from the patient that indicates the degree or measurement of how bad the chief complaint is. This rating not only is documented based on 0-10 scale, but it can be captured using phrases such as: worsening, improving, and increasing. An auditor performing a medical necessity…

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Posted and filed under Healthcare.
health costs

Template to Fulfill Home Health Requirements

Open door forums are being held to discuss the use of a template to aid in fulfilling the face-to-face requirement for Medicare beneficiaries receiving home health care. “In fiscal year (FY) 2014, the Comprehensive Error Rate Testing (CERT) program found that more than half (51.4 percent) of the home health claims were paid improperly. Of…

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Posted and filed under Coding, Healthcare.
pain management

Pain Management Specialty

The pain management specialty has seen more than its share of coding and reimbursement changes throughout the past few years. 2015 brought another round of changes for this specialty: a major revision to a commonly used coding set, reimbursement rate changes, and bundling of needle placement guidance with joint injections, to name a few.  …

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Posted and filed under FWA, Healthcare.
Gavel and Stethescope

12 Healthcare Fraud, Waste, & Abuse Facts

Fraud accounts for 19% of the $600 to $800B in waste in the U.S. healthcare system annually, including everything from bogus Medicare claims to kickbacks for worthless treatments and other services. 57% of insurers expect to see an increase in fraud losses this year on personal insurance lines (mainly auto and home insurance), while only 5% of…

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Posted and filed under Compliance, Healthcare.
Norma Panther and Maria Candia

Is Anyone Truly HIPAA Compliant in Healthcare?

Advize Health presented “Is Anyone Truly HIPAA Compliant in Healthcare?” to ISACA West Florida Chapter’s Tampa Governance Risk and Compliance (GRC) Conference. Highlights included: Understanding HIPAA Breach / Violation Statistics Breach Examples Why We Should Care? As Seen At Our Clients: Providers Payers Where is HIPAA Heading? Compliance issues investigated most (in order of frequency)…

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Posted and filed under Compliance, Payers.
physician arms crossed

Quality Measuring Tools for Payers

How important is quality to you? For most people, quality – which equates to a measure of excellence and meeting strict standards – is one of the most important factors in most decision-making related to consumer goods and products. Take the automobile industry; uses the example that “if an automobile company finds a defect…

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Posted and filed under Events, Healthcare.
healthcon 2015

Greetings from HealthCon 2015!

This month’s Enlighten Newsletter comes to you from Las Vegas, where Advize Health is participating in HealthCon 2015, AAPC’s 23rd annual conference. If you’re at the show, be sure to follow Advize Health on Twitter and LinkedIn for updates! As a leader in the coding industry, Advize Health is continually curating the latest and greatest news and trends in the industry. We…

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