Welter Healthcare Partners Renews Contract With Colorado Department Of Public Health

Screen Shot 2014-03-21 at 11.37.53 AM Welter Healthcare Partners is proud to announce that we’ve received approval to renew our contract with the State of Colorado Department of Public Health and Environment. We will continue to assist with medical clinics covering the topics of:n

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  • Billing
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  • Coding
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  • Managed care contracting
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n Welter Healthcare Partners is currently working with local public health agencies and state and national public health leaders to address these issues. We are actively assisting large and small public health departments across the country by providing:n

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  • Comprehensive assessments of current capacity, structure, resources, systems and personnel with recommendations for moving forward
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  • Strategic planning and implementation services
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  • Revenue cycle management
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  • Billing and A/R management services
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  • Insurance contracting and credentialing
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  • Provider coding and documentation training, including ICD-10 training
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  • Practice management and electronic medical records (EMR) implementation
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nCheck out page 31 of the January/February publication of Colorado Medicine, below, which features an article covering the work of our own Todd Welter!nn

CURRENT ICD-10 CODES

 nn nnPlease, do not feed the wildlife…nS61.451A: Open bite of right hand, initial encounternW55.81XA: Bitten by mountain lionnY93.01: Activity, hikingnn 

CURRENT TODD'S TIPS

 nn nnBilling/Accounts Receivables/Revenue Cycle Management:  The blood that keeps a practice alive:nnPick a patient seen one month ago and follow that revenue cycle.  Look at the claim, compare it to the notes, has it been paid?  Did the patient pay a co-payment or deductible if so when? (Co-payments and deductibles should be paid at the time of service).  Did the insurance pay, if a clean claim was sent electronically it should be paid within 30 days. Was it paid properly? How do you know?   If it hasn’t been paid, find out why!  Revenue Cycle is a Cycle!  Follow it!  You may be surprised at what you find.nn 

Alternative Payment Models For Healthcare Industry

Federal Agencies adopt new tactics for healthcare industry to alternative payment models in medicine.

nAlternative Payment Models For Healthcare Industry The Department of Health and Human Services has pushed forward several alternative payment models for the healthcare industry.nnIn recent years, the federal government has positioned the healthcare industry to adopt new reimbursement tactics aimed at strengthening pay-for-performance initiatives. These regulations consist of alternative payment models such as bundled payments or value-based care reimbursement. The Centers for Medicare & Medicaid Services (CMS), for instance, established the Comprehensive Care for Joint Replacement Model, which consists of implementing bundled payments or reimbursement based on an episode of care within hip and knee replacement surgeries.The proposed rule for the bundled payment model was initially was published on July 9, 2015 and the finalized legislation was made available on November 16, 2015. The start date of the Comprehensive Care for Joint Replacement Model is set for April 1, 2016. “The CJR [Comprehensive Care for Joint Replacement] model holds participant hospitals financially accountable for the quality and cost of a CJR episode of care and incentivizes increased coordination of care among hospitals, physicians, and post-acute care providers,” CMS stated on its website.nn“The episode of care begins with an admission to a participant hospital of a beneficiary who is ultimately discharged under MS-DRG 469 (Major joint replacement or reattachment of lower extremity with major complications or comorbidities) or 470 (Major joint replacement or reattachment of lower extremity without major complications or comorbidities) and ends 90 days post-discharge in order to cover the complete period of recovery for beneficiaries. The episode includes all related items and services paid under Medicare Part A and Part B for all Medicare fee-for-service beneficiaries, with the exception of certain exclusions.” CMS has had a rich history of supporting bundled payment models starting in the 1980s when an inpatient prospective payment system was created. This was the first step in which the Medicare program reimbursed hospitals based on a fixed amount for each patient’s hospital stay and diagnosis.n

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nThis article is originally posted on Revcycleintelligence.com.

New Obstacles Arise For the Electronic Health Record Market

Big Data and Analytics Encounter Roadblocks in the Form of EHR Costs

nNew Obstacles Arise For the Electronic Health Record MarketHospitals amassing more and more administrative, clinical, financial and ICD-10 data are looking to harness statistics, data science and mining tools and the electronic health record market is expanding but new obstacles are arising. nnThe predictive analytics market is gaining traction and driving EHR growth. But in something of a twist the costs of new EHR tools are simultaneously creating a significant barrier to big data and analytics, according to a new Research and Markets report.nnIndeed, as healthcare providers continue to amass copious amounts of healthcare data, including clinical, administrative and financial information as well as the shift from ICD-9 to ICD-10, are all leading healthcare organizations to implement analytics tools to make use of accrued data, according to the report.nnEHR adoption, meanwhile, is growing among healthcare providers, and the market will continue to expand at a CGR of 5.53 percent over the next four years, Research and Markets projected.nn“One trend impelling growth in this market is the increased adoption of predictive analytics,” one of the report’s analysts commented. “The ever increasing volume variety, and velocity of clinical and non-clinical data have compelled healthcare organizations to implement statistical tools, data science and mining technology.”nnBut implementation of healthcare information systems, encompassing EHR software, hardware and network installation costs, are also some of the greatest hindrances en route to a future of big data and predictive analytics, Research and Markets noted.nnWhat’s more, the extra hardware and software installation involved when integrating EHR systems with pharmacy and laboratory data may prove to be too expensive for smaller hospitals and providers in developing countries to put new analytics to work anytime soon, the report said.nnThis article was originally posted on HealthCareITNews.com.

Small Medical Practices to Benefit From Newly Proposed QPP Rule

Check out this article about small businesses and how they can benefit from an exemption from EHR requirements!Small Medical Practices to Benefit From Newly Proposed QPP Rule nnMore small practices may qualify for exclusions from the Quality Payment Program (QPP), claim hardship exceptions from electronic health record (EHR) requirements, and earn automatic bonus points if the proposed QPP rule released June 20 is finalized.nnThe Centers for Medicare & Medicad Services has proposed increasing two low-volume thresholds that would grant additional exclusions in 2018:n

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  1. Practices that bill less than $90,000 in Part B charges.
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  3. Practices that see fewer than 200 Medicare patients.
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nThese practices would be exempt from QPP requirements in 2018. Those figures are up from $30,000 in Part B charges and 100 Medicare patients in 2017.nnSmall practices, defined as having 15 or fewer eligible clinicians, also could add five points to their total performance scores in the merit-based incentive payment system (MIPS) “as long as the eligible clinician or group submits data on at least one performance category in the applicable performance period.” That would get them closer to the proposed 15-point performance threshold. Eligible providers that don’t fit within those categories would have to meet these QPP requirements to avoid a 5% cut, or potentially earn a 5% bonus in 2020, according to the proposed rule.n

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nThis article was originally posted on HealthMediaLeaders.com