Apr 11, 2016 | Uncategorized
Supply and demand pressures are rising when it comes to healthcare. Yes, healthcare has supply and demand in America, regardless of our opinions on this matter! nnYes, it does apply to healthcare, believe it or not. There are supply and demand pressures in pricing and in reimbursement, etc. There is even elasticity and inelasticity in cost and supply. In healthcare sometimes it can work backwards: like when more supply creates its own demand for services.nnThe one area that is an absolute is the power of the providers pen! In the American system only a credentialed provider can order tests, admit, discharge and even refer patients. Why is this sword so powerful, you ask? Because it comes attached to the providers license, education, their experience and their professional liability all of which have a cost! That cost needs to be covered by reimbursement! (Think beyond fee-for-service.) If you are being asked to participate in a program, a study, a new methodology and it needs a provider’s pen (the almighty order sword) to make it work you should be paid for it!nn nn
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About R. Todd Welter • MS, CPCnFounder and President of Welter Healthcare Partners
nMr. Welter has over 25 years of healthcare industry experience assisting physicians and other providers, hospitals and other facilities with the business side of medicine. Through strategic planning and analysis, Mr. Welter’s main focus is to strategically increase revenues and profitability in this radically changing health care environment.
Mr. Welter has a Masters Degree in Organizational Leadership from Regis University in Denver where he has had an appointment as affiliate faculty in the School for Professional Studies for over ten years. In addition, Mr. Welter holds a faculty appointment at the University of Denver’s University College. In the Health Care Leadership program he teaches Macro Economics in Health Care and Innovative Strategies and Change in Health Care to graduate students.
Apr 11, 2016 | Uncategorized
Written By: Toni M. Woods, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer, Director of Coding/Compliancenn
This year many are anticipating the first update to the ICD-10 code set after a lengthy 5 year code freeze. Annually, new codes are added, revised, and deleted and with this being the first year of federally mandated use for the brand new code set, everyone is hoping for clarification on many coding conundrums that have perplexed us over the past year.nnOf note, this year’s updates will include 2,670 proposed code changes, which will take effect on October 1, 2016. The updates will be released and published on the CDC’s website in June, about 5 months before implementation is required.n
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- 1,943 new additions to the 2017 ICD-10-CM code setn
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- There will be 885 new codes added to Chapter 19 (Injuries Chapter), which will include increased site specificity for fracture codes of the following sites: neck, base of skull, facial bones, Salter-Harris calcaneal fractures, and other fractures.
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- There will be 260 new diabetes combination codes to report commonly associated manifestations and complications.
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- There will be 152 new codes added to Chapter 13 (Musculoskeletal Chapter), which will include additional classifications for bunions, temporomandibular joint conditions, cervical spine disorders and atypical femoral fractures.
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- 422 revised codes will be included in the 2017 ICD-10-CM code set
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- 305 codes will be deleted from the 2017 ICD-10-CM code set
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nThe Welter Healthcare Partners coding department (based on client requests) are imploring for the following, much needed ICD-10-CM changes/clarifications:n
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- More concrete guidance on the 7th character applications in Chapter 19
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- When aftercare Z codes are appropriate instead of injury codes as it pertains to Orthopedics
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- Better code options for Nexplanon contraceptive management
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- Clarification on the use of wellness Z codes
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- Clinical guidance and examples on the dependence classifications for nicotine, which include: uncomplicated, in remission, with withdrawal, with other nicotine-induced disorders, and unspecified nicotine-induced disorders
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nnNow is the time to identify gaps, get the training your practice/organization needs, and conduct documentation queries. We recommend participating in Welter Healthcare Partners’s ICD-10 PUSH Program (Persist Until Success Happens) to ensure a smooth, successful transition, and to avoid claim denials and payment delays. Let our experts help make your job easier! Contact us today!
Mar 31, 2016 | Uncategorized
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Mar 31, 2016 | Uncategorized
Did you know we now offer recruitment services? With our medical practice management experience, we CAN bring you the best candidates to fit your organization, and at a lower placement fee!nnHealth Care is a service business. Good medical services require good personnel. Good personnel make for happy customers, good patient flow, an efficient and effective practice, good team morale and productivity, and overall a well-oiled machine!nnOur Recruitment Services will find you good, qualified personnel who will be great additions to your team. We will do all of the legwork for you and we will deliver to you only the best candidates, based on your criteria. And we do it all for a 10% placement fee, the lowest fee in the market! Our services are proactive! We find candidates by using ALL of the tools available – we go find the candidates, we don’t wait for them to contact us!nnWe find multiple qualified candidates who meet your specific criteria, we then conduct:n
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- Initial phone conversation
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- Face-to-face interview
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- Reference Checks
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- Background Check
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- Skills Testing
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Click Here to Learn More
Mar 16, 2016 | Uncategorized
Z77.110 — Contact with and (suspected) exposure to air pollutionnnZ77.128 — Contact with and (suspected) exposure to other hazards in the physical environmentnnK90.1 — Cochin-China diarrhea
Mar 16, 2016 | Uncategorized
Welter Healthcare Partners is thrilled to announce that our own R. Todd Welter recently revisited Beijing, China to work directly with healthcare professionals in providing insight to the American Healthcare System.nnCEO of Welter Healthcare Partners, R. Todd Welter went to visit 5 hospitals in 5 days in a whirlwind trip to Beijing, China (now a city of over 20 million people) to provide area medical professionals with insight to how the American Healthcare System works. Welter spoke on topics of medical coding and revenue cycles… and a bit about American politics.nnWelter visited China back in 2004 for a similar trip, and the hospital associates there were anxious to meet with the American medical billing and healthcare expert again. For insight into his trip, and a review of the 2004 venture, check out an article by Welter, below.n
Third-Party Payer Committee
nBy Todd WelternnBilling and Coding, Medical Records and Managing HealthcarennI am in Beijing China, a city of over 10 million. I was invited by a Swiss company to attend The Chinese Orthopedic Association’s National Congress. Over 2,500 Chinese physicians will attend to hear discussions on the latest surgical procedures, new products, and new ideas on patient care. I have traveled with my friend Dr. Michael Janssen, an internationally known and well-respected orthopedic spine surgeon. Dr. Janssen has an orthopedic spine surgery practice in Thornton, Colorado.nnIn addition to our official duties, the obvious tourist opportunities, and the many complex social events we are invited to, I am determined to learn as much as I can about the Chinese healthcare system, how it is financed, how records are kept, and how the physicians are compensated (who said healthcare business consulting is boring?)nn[vc_toggle title=”CLICK HERE TO READ MORE” size=”sm” el_id=””]The Chinese system for coding is not as specific as ours. Even though they perform essentially the same services and procedures, they record very basic, general service descriptions. They then have a fixed fee schedule for all services. The patient pays for medical care, many times in advance. If it is not paid for, it is simply not done.nnThe Chinese people, those living in the larger cities at least, have insurance. In China, employers pay for the insurance. Most of the time the insurance pays very minimally and the remainder is paid by the patient or their family or outright by their employer.nnI am visiting the Beijing General Military Hospital, a sprawling 1,100 bed facility in the heart of Beijing, a few minutes from Tiananmen Square. Our hosts tell me that this is the best hospital in all of Beijing. I find the facility to be very “1950’s Institutional.” Stark white tiled walls and floors. No patient amenities (televisions, bathrooms in the rooms, etc.). Other than that, the set up is very similar with one very notable exception. In China, the patient’s family is expected to play a big part in the patient’s care. The patient’s family does a lot of what we call nursing care (food, patient comfort, even moderate physical therapy). Every patient room I saw had at least one extra bed in it for a family member.nnI was very privileged to be able to discuss the Chinese systems of record keeping, coding, charges, and reimbursement with the hospital’s Vice President of Finance who is also a gastroenterologist. All the physicians at this hospital are employed by the hospital. Many have apartments on the grounds of the massive complex. Physicians are paid a salary and then receive bonus pay based on their productivity (number of cases, patients seen, etc.). Physicians are also able to receive additional compensation for a wide variety of other efforts, some officially frowned upon but openly accepted.nnThe hospital and physicians use a single electronic medical record. Computers throughout the facility are able to access a patient’s record, charges, physician notes, nursing notes, etc.nnOne area of great difference is the concept of outpatient surgery. The Chinese do not perform “outpatient surgery.” Part of our visit to the facility included a session with the Orthopedic Department to do case reviews. There was a kind of International Grand Rounds done with Dr. Janssen from Denver and a physician from Prague. The Chinese physicians discussed several cases and presented their x-ray results, including MRI. As it turns out, a procedure that could be done in Denver in 30 minutes with a 4-hour stay in an outpatient facility would result in at least a 2-day in-patient stay in China.nnThe Chinese system appeared to equal ours; in fact they perform the same complex procedures we perform (open heart surgery, complex spine and neurosurgery, transplants, etc.) in addition to all the more routine services. Their system was, however, remarkable for it being less efficient than ours. On the provider side, it appeared that their system is hospital-centered rather than physician-centered. They therefore, don’t seem to be as concerned about seeing as many patients as possible, turning around O.R. rooms quickly and getting the patients out of the hospital as soon as possible. I was struck by this difference.nnBased on this trip, other international visits, and even many domestic observations, I am starting to conclude that the American system of healthcare, with all its apparent blemishes, owes its efficiency to American physicians playing such an important role in it. The concept of system efficiency is lost to the Chinese, because it is a hospital-centered system. The lesson in this may be to protect and, in fact, strengthen the physician’s role in healthcare rather than allow it to continually erode. It appears, by observation, that when there is a system which does not allow the physician to initiate care, make decisions, order, admit and discharge while compensating him/her to do so in a way that values this expertise, the system suffers from inefficiencies, lack of creativity, and thus higher costs.nnBeing a coder at heart, I brought a 2004 CPT book with me and showed it to them. Its level of detail mesmerized them. We agreed to exchange pricing information and I was allowed to photograph much of the facility including patient rooms, patients, and even a medical record. (Something we could never do here.) The company who invited me to China is sending me a large package of information on the Chinese healthcare system for follow-up.nnThe President of the Beijing General Military Hospital presented us gifts. He gave Dr. Janssen the title of Honorary Chairman of the Orthopedic Department (a very high honor) and presented me with a traditional Chinese tea set (something we will cherish at my home). I plan to send him a copy of John Fielder’s book of Colorado photographs and, of course, a CPT book.nnThis article originally posted on CMGMA.com.[/vc_toggle]
