ICD-10… It’s a Good Thing… Really!

ICD-10... It’s a Good Thing… Really!Healthcare is at its core based on science. It is the science of accurately diagnosing and treating the sick and wounded. That being said, how can having more specific information be a bad thing? How can having more data from which to make decisions be a bad thing? Will it be a hard switch to make?—Of course it will. It will be a first class pain in the tush. But, it will be a good thing in the end. ICD-10 will make accurate diagnosing of issues easier, more accurate and the ability to track what works and what does not work better, easier and faster.nnStay tuned for more Todd’s Tips!nn


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Todd150About 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.

Can't Stand the Heat, Get Out of the Kitchen

Can't Stand the Heat, Get Out of the KitchenX15.0XXA — Contact with hot stove (kitchen), initial encounternX15.1XXA — Contact with hot toaster, initial encounternY93.G3 — Activity, cooking and bakingnY27.2 — Contact with hot fluidsnnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2015 implementation date. Please don’t hesitate to contact us for all of your training and education needs!

ICD-10 Preparation: Start Testing with Payers!

ICD-10 Preparation: Start Testing with Payers!Communicating with healthcare payers is a process, one involving more than simply handing them a medical claim. Here are some tips to help with the process.nnCreating better relationships with your payers before Oct. 1, in fact, enables providers to glean important insights about testing results, changes to reimbursement, how to handle denied claims. Early communication will also help healthcare providers test the ICD-10 claims process and prepare for DRG shifts. This puts a price tag on procrastination.nnBut how to begin?n

The first step is to survey healthcare payers to understand ICD-10 readiness by asking:

n1. Are you prepared to meet the ICD-10 deadline of Oct. 1?n2. Where is your organization in the transition process?n3. Will you conduct external testing?n4. What will we need to test with you?n5. When will you be ready to accept test transactions from my practice?n6. Will you be dual processing, and if so, when will you start?n7. What will happen if something goes wrong?n8. Who will be my primary contact at your organization for the ICD-10 transition?n9. Can we set up regular check-in meetings to keep our progress on track?n10. Do you anticipate any changes in policies or delays in payments to result from the switch to ICD-10?nnIn return, providers should expect to communicate the status of your transition, establish regular check-ins, and be willing to share any information, particularly surprises, with your payers.nnThis part of the ICD-10 transition will take time and effort but there will be reward — less financial disruption and stress.nnThis article originally posted on GovHealthIT.com.

Springtime Blues?

Springtime Blues?R45.1 — Restlessness and agitationnR45.2 — UnhappinessnR45.3 — Demoralization and apathynR45.4 — Irritability and angernnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2015 implementation date. Please don’t hesitate to contact us for all of your training and education needs!

It Is All About "The Spend"

It Is All About "The Spend"Your providers see waste in the system every day.nnServices that are done (by other providers and facilities), but not needed for a particular patient’s care—Make note of these! Use them when you sit down to re-negotiate your next rate increase with the payers. You don’t need the specific patients (this is protected information), you need to make it known that paying you well, will help you help them.n

I know how you (payer) can save on my cases….nnI can take more cases to an Ambulatory Care CenternnI can use this radiology location rather than the hospitals…nnBut, you have to meet me halfway, share the savings, give me a goal for savings and I will exceed it…

nStay tuned for more Todd’s Tips!nn


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Todd150About 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.

Self–Funded Plans

In most markets half, or more, of the payer lives are in self-funded plans

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Self–Funded Plans

nThis means the “insurance company” is not really providing an Insured Product—they simply administer the plan. The actual payer, at the end of the day, is the employer themselves. All of these employers have a Human Resources Department (or something similar) and they all have a Director. Ask your patients who their Director of HR is, and do your best to meet him/her.nnFind out their pain points! Ask them… “How can my practice help you?”  If nothing else, you will have a friend on the inside.  Maybe you can get more patient volume, set up a clinic, do an in-service…nnStay tuned for more Todd’s Tips!nn


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Todd150About 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.

SGR Bill Passed By Senate With No ICD-10 Delay

shutterstock_244278724The United States Senate just passed the SGR Bill, which includes no indication of a further delay of the ICD-10 transition deadline.nnIn a move that took over a decade to accomplish, the Senate voted 92-8 late Tuesday to repeal the sustainable growth rate (SGR) formula that adjusts Medicare payments to physicians.nnThe bill, H.R. 2, the Medicare Access and CHIP Reauthorization Act, did not include any references to ICD-10 implementation or an ICD-10 delay. The bill now moves to President Obama, who has indicated that he would sign the bill, according to a statement posted on the White House’s website.nnThe SGR repeal was seen by ICD-10 proponents as a major hurdle to overcome, who in 2014 saw a last minute ICD-10 delay slipped into SGR legislation that put off implementation of the new code set until October 1, 2015.nnThough six amendments were voted on during the Senate debate, none of the amendments included language that would have impacted ICD-10.n

CLICK HERE TO READ MORE

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ARE YOU READY? ICD-10 Coder Academy – Sign Up Today and Save On Registration!

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roadtoicd-10

nThis interactive and hands-on ICD-10 training is designed to prepare coders for the AAPC and AHIMA ICD-10 proficiency examinations. Participants will gain the tools they need to appropriately select ICD-10-CM codes. These training sessions will be coder centric, and the content will be designed for those staff who will be responsible for applying (or verifying) these codes to documentation. Throughout the academy, participants will be given an assortment of scenarios to code to obtain the proficiency they need for coding in ICD-10.n

CLICK HERE TO LEARN MORE

nThis article originally posted on AHIMA.org.

ICD-10 Coder Academy – Sign Up Today and Save On Registration!

RT_WelterCode_OnnnThis interactive and hands-on ICD-10 training is designed to prepare coders for the AAPC and AHIMA ICD-10 proficiency examinations. This training is also appropriate for experienced billers that perform coding as part of their job responsibilities. Participants will gain the tools they need to appropriately select ICD-10-CM codes. These training sessions will be coder centric, and the content will be designed for those staff who will be responsible for applying (or verifying) these codes to documentation. Throughout the academy, participants will be given an assortment of scenarios to code to obtain the proficiency they need for coding in ICD-10.n

Overview of ICD-10 Academy Agenda:

nICD-10-CMnnnAHIMA-approved ICD-10 trainers will educate coding staff regarding ICD-10-CM with a focus on:n

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  • Convention changes and additions
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  • Concept changes and additions
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  • Chapter specific guideline changes and additions
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  • Live coding workshop
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n**This training has the approval of 8.0 CEU’s from the American Health Information Management Association (AHIMA) (AAPC members can submit these CEU’s to AAPC for credit)nn[dt_divider style=”thin” /]n

Click here for detailed training agenda

n[vc_toggle title=”Required Academy Materials:” size=”sm” el_id=””]AHIMA ICD-10-CM Coder Training Manual – Upon registration participants will have an ICD-10 Book and Training Manual ordered on their behalf – cost is $100.00 for the ICD-10 book and $90.00 for the training manual ($190.00 total) and will be added to the registration fee. If you already have an ICD-10 book, you may use it (please indicate this on the registration form). For interested participants we can also order ICD-10 flash cards on your behalf to help in your ongoing studying efforts ($10.00 – see registration form)!nn**Book Pick-Up: In order for pre-requisites to be completed prior to the actual course date, participants will be required to pick up their books from 8am – 5pm, at Welter Healthcare Partners headquarters (unless specified otherwise) at 6870 W. 52nd Avenue, Suite 102, Arvada, CO 80002 on:n

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  • Friday, June 26, 2015 – for the June 30, 2015 Coder Academy
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  • July 15-17, 2015, 8am-5pm at the El Paso County Medical Society office at 1465 Kelly Johnson Blvd, Suite 130, Colorado Springs, CO 80920 – for the July 21, 2015 Coder Academy
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  • Friday July 24, 2015 – for the August 6, 2015 Coder Academy
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  • Friday, July 31, 2015 – for the August 13, 2015 Coder Academy
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nIf you need to make alternative arrangements to pick up your books, please contact Dianna Gilmore at 303.534.0388.[/vc_toggle]nn[vc_toggle title=”Academy Pre-Requisites:” size=”sm” el_id=””]ICD-10-CM:nICD-10-CM Coder Training Manual: Pages 2-82; Reading and accompanying section review questions[divider_flat][/vc_toggle]nn[vc_toggle title=”Academy Dates and Locations:” size=”sm” el_id=””]**Lunch break is from 12-1pm. We reduced the cost of the training by eliminating food/drink costs for the participants. You may bring your own drinks/snacks/lunch or go out for lunch. nnLakewood, COnJune 30, 2015n9:00am – 5:00pmn(Check-in at 8:45am)nSt. Anthony HospitalnCancer Conference Centern(Medical Office Plaza 1)n11750 W. 2nd PlacenLakewood, CO 80228nRegistration Deadline:nJune 8, 2015 Colorado Springs, COnJuly 21, 2015n8:00am – 5:00pmn(Check-in at 7:45am)nThe Space FoundationnArea 51 Conference Roomn4425 Arrowswest DrivenColorado Springs, CO 80907nRegistration Deadline:nJune 26, 2015 Englewood, COnAugust 6, 2015n8:00am – 5:00pmn(Check-in at 7:45am)nSwedish Medical CenternSpruce A and BnConference Roomsn501 E. Hampden AvenuenEnglewood, CO 80113nRegistration Deadline:nJuly 10, 2015 Thornton, COnAugust 13, 2015n8:00am – 5:00pmn(Check-in at 7:45am)nSpine Educationn& Research Instituten9005 Grant Street, Suite 100nThornton, CO 80229nRegistration Deadline:nJuly 17, 2015 [/vc_toggle]nnAcademy Registration Fee:nnICD-10-CM Only — $175.00 per participant (plus $190.00 for the training manual and the ICD-10-CM book)n

Registration Discounts:

nPractices registering 3+ participants will receive $25.00 off each registration.n

Seating is limited, register now to guarantee your spot today!

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Click here for registration form

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Course Instructor:

nToni Woods, CCS, CPCnMs. Woods is an AHIMA-Approved ICD-10-CM/PCS Trainer. She educates and trains in the areas of ICD-10, physician documentation, Medicare coding and documentation guidelines, ambulatory medicine coding, hospital, and other facility coding and documentation. She works with physician practices of all specialties and is an expert in analyzing chart documentation and in reengineering practices to enhance their reimbursement systems and processes, and overall increase revenue and profitability. Her goal is to empower physicians and health care professionals and staff to understand the language of the coding and billing world, and to give them the tools they need for successful reporting and reimbursement of their services. Ms. Woods is enthusiastic about the future of ICD-10 and is on the forefront of providing ICD-10-CM/PCS education and implementation processes.nnFor more information or to register, please contact Jennifer at Welter Healthcare Partners at 303.534.0388 or jh@WHPelter.com

Spring Has Sprung

Spring Has SprungJ30.1 — Allergic rhinitis due to pollennJ30.2 — Other seasonal allergic rhinitisnJ30.81 — Allergic rhinitis due to animal (cat) (dog) hair and dandernJ30.89 — Other allergic rhinitisnnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2015 implementation date. Please don’t hesitate to contact us for all of your training and education needs!

Know Your Payer Representatives

Do you know the payer representatives? Find out who they are and develop a relationship! Usually there is someone assigned to you. Invite them to drop in for lunch. They are not the enemy and very often a good relationship can pay big dividends when you need help with a problem claim, or when it is time to negotiate a new agreement.nnStay tuned for more Todd’s Tips!nn


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Todd150About 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.

The Doc Fix

The Doc FixThe US Senate has recessed without taking up the Doc Fix

nWe were so close to finally doing away with the SGR (Sustainable Growth Rate) calculation which has held good medical care hostage year after year. The House of Representatives sent through a bi-partisan bill to the Senate, the President was ready to sign, and the Senate dropped the ball.nnConsequently, the 21% cut in reimbursement is set to take affect April 1, 2015. We encourage you to exercise your right to make your representatives in Washington aware of your contempt.

Proposed SGR Bill Could Change Physician Reimbursement, Interoperability

Proposed SGR Bill Could Change Physician Reimbursement, InteroperabilityThe proposed permanent fix to the sustainable growth rate (SGR) formula may bring big changes to interoperability.nnRep. Michael Burgess (R-Tex.) has introduced H.R. 1470 to repeal and replace the Sustainable Growth Rate formula that Medicare uses to pay physicians. The bill as introduced does not include language to change policy on the ICD-10 compliance date or the two-midnight rule pertaining to hospital payments. However, it does lay out a program to have “widespread” electronic health records interoperability in 2019, with the threat that certified EHRs not supporting interoperability could be decertified.nn“As a consequence of a significant Federal investment in the implementation of health information technology through the Medicare and Medicaid EHR incentive programs, Congress declares it a national objective to achieve widespread exchange of health information through interoperable EHR technology nationwide by December, 31, 2018,” according to the 158-page bill, available here.nnBurgess’ legislation, which won’t be the only SGR bill being considered in the House and Senate, defines widespread interoperability as meaning “interoperability between certified EHR systems employed by meaningful EHR users under the Medicare and Medicaid EHR incentive programs and other clinicians and healthcare providers on a nationwide basis.” The bill includes incentives, such as streamlined quality reporting, for providers who are not eligible for the meaningful use program to use certified EHRs.nnIn the legislation, interoperability is defined as “the ability of two or more health information systems or components to exchange clinical and other information and to use the information that has been exchanged using common standards as to provide access to longitudinal information for health care providers in order to facilitate coordinated care and improved patient outcomes.”nnicd10_EHR-resized-600Further, the Department of Health and Human Services would be tasked to establish metrics to identify the extent to which interoperability objectives are being achieved, and to submit a report to Congress identifying objectives not being met along with recommendations to get them back on track. These recommended actions could include: “to adjust payments for not being meaningful EHR users under the Medicare EHR incentive programs;” and “criteria for decertifying certified EHR technology products.”nnThe legislation also calls for EHR users to demonstrate, possibly through attestation, that they have not “knowingly and willfully taken action (such as to disable functionality) to limit or restrict the compatibility or interoperability of the certified EHR technology.”nnThis article originally posted on HealthDataManagement.comnn


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Related Services and Resources from Welter Healthcare Partners:

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Certified Practice Management and Electronic Medical Record SoftwarenCertified Professional Coder Preparation Course & CertificationnCHIEF ICD-10 Implementation Plan – Get Started Today!nICD-10-CM and ICD-10-PCS Coder Academy[nCoding & Documentation Quickinars

Baby Got Back (Pain)…

Baby Got Back (Pain)… — Fun with ICD-10M54.5 — Low back painnM54.6 — Pain in thoracic spinenM54.9 — Backache NOSnM54.41 — Lumbago with sciatica, right sidennIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2015 implementation date. Please don’t hesitate to contact us for all of your training and education needs!

Cash Pay Service Reminders

Cash Pay Service RemindersAsk your patients if they have a cafeteria plan at work. Money has to be spent by the end of the year! Keep track and start sending out cash pay service reminders mid October.nnStay tuned for more Todd’s Tips!nn


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Todd150About 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.

Transparency In Referrals

Transparency In ReferralsA major problem we have in health care today is transparency.n

Add to your referral process —(I hear the groan).

nAsk those you are referring to what their charge AND acceptable payment will be. You will be interested to see the reaction, and answer.nnStay tuned for more Todd’s Tips!nn


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Todd150About 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.

Winter Blues

Winter Blues — Fun with ICD-10F32.0 — Major depressive disorder, single episode, mildnF33.1 — Seasonal depressive disorder, recurrent, moderatenF43.21 — Adjustment disorder with depressed moodnnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2015 implementation date. Please don’t hesitate to contact us for all of your training and education needs!

E/M Coding Calculator from Welter Healthcare Partners

E/M Coding Calculator from  Welter Healthcare PartnersThe E/M Coding Calculator is a resource designed to assist providers with appropriate code selection for evaluation and management services. This tool is a simplified version of the Novitas auditor’s instructions, and can be used as a guide to understand the evaluation and management coding and documentation guidelines.nnPage One includes a snapshot of the levels of service used in the outpatient care setting and their documentation requirements. Page One also includes time thresholds for each level of E/M service, and the specific documentation requirements for time-based billing.nnPage Two includes the formula for calculating history, exam, and medical-decision-making along with a table outlining the differences between body areas and organ systems, which is particularly important when calculating physical exam.nn nn nnn n

CLICK HERE TO VIEW PRINTABLE VERSION OF E/M CODING CALCULATOR

Health Savings Accounts (HSA)

shutterstock_85920487Ask your patients if they have an HSA (Health Savings Account)! They will appreciate your inquiry. Keep track of those patients and run HSA specials! Have HSA specials on cash pay services at slow volume times.nnA health savings account (HSA) is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a high-deductible health plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit. Unlike a flexible spending account (FSA), funds roll over and accumulate year to year if not spent. HSAs are owned by the individual, which differentiates them from company-owned Health Reimbursement Arrangements (HRA) that are an alternate tax-deductible source of funds paired with either HDHPs or standard health plans. HSA funds may currently be used to pay for qualified medical expenses at any time without federal tax liability or penalty.nnStay tuned for more Todd’s Tips!nn


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Todd150About 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.

What Makes Your Heart Skip A Beat?

What Makes Your Heart Skip A Beat? — Fun With ICD-10R00.2 — PalpitationsnR00.0 — Rapid heart beatnI48.0 — Paroxysmal atrial fibrillationnI48.4 — Atypical atrial flutternnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2015 implementation date. Please don’t hesitate to contact us for all of your training and education needs!

ICD-10 Congressional Hearing Panelists Debate Implementation

ICD-10 Congressional Hearing Panelists Debate ImplementationHealthcare professionals that work with coded data on a daily basis were well represented in the US House of Representatives’ Energy and Commerce Subcommittee on Health hearing, titled “Examining ICD-10 Implementation,” which took place Wednesday morning in Washington, DC.n

ICD-10 Congressional Hearing Panelists Debate Implementation Myths, Industry Impact, and Readiness

nWith panelists representing those both for and against an outright switch to the new ICD-10 code set on October 1, 2015, the subcommittee representatives listened to debate on stakeholder ICD-10 readiness, implementation costs, and the impact another delay would have on the healthcare industry. (Click here to view a video replay of the hearing.)nnPanelist Sue Bowman, MJ, RHIA, CCS, FAHIMA, AHIMA’s senior director of coding policy and compliance, urged Congress in her testimony not to enact further delays and allow the US to keep pace with other industrialized nations who adopted ICD-10 years ago.nn“So the industry initially had more than four years after publication of the final rule to prepare for the ICD-10 transition. As a result of the two one-year delays granted by HHS [Department of Health and Human Services] in 2012 and Congress in 2014, the healthcare industry has had more than six years to prepare,” Bowman said. “This length of time is more than adequate for all segments of the healthcare industry to be ready for the transition.”nnICD-10 Congressional Hearing Panelists Debate ImplementationPanelist William Jefferson Terry, MD, representing the American Urological Association, as well as his own practice, voiced concerns about lost physician productivity if ICD-10 is adopted too quickly.nn“Physicians are overwhelmed with the tsunami of regulations that have significantly increased the volume of work for physicians and their staff, many of which have questionable value to improving the quality of care provided to patients,” Terry stated during the hearing. “Many physician practices, especially the rural one- or two-physician practices do not have the time, money, or expertise to follow and comply with the mounting regulatory challenges, which is why many are considering early retirement or opting out of the Medicare program.”nnProponents of implementing ICD-10-CM/PCS on the October 1, 2015 deadline likely left the hearing with optimism, based on the testimony of the panelists and comments from key committee members.nnAt the outset of the hearing, Rep. Joe Pitts (R-PA), the subcommittee’s chairman, voiced his support for moving forward with ICD-10 implementation in October 2015. This was particularly notable since the delay language was added to a bill Pitts introduced in last year’s “Protecting Access to Medicare” bill that delayed ICD-10 implementation by an additional year.nnICD-10 Congressional Hearing Panelists Debate ImplementationRep. Kathy Castor (D-FL) also spoke out in support of an October 2015 implementation, and Rep. Tony Cardenas (D-CA) noted the California Hospital Association’s advocacy efforts to keep implementation on track for this year.nnOf the seven industry experts who testified today, only one—Terry, from the Mobile Urology Group—outright opposed implementation in 2015. ICD-10 advocate panelists at the hearing included Edwin M. Burke, MD, from the Beyer Medical Group; Richard Averill, from 3M Health Information Systems; Kristi A. Matus, from insurer Athena Health; Carmella Bocchino, from America’s Health Insurance Plans (AHIP); and John Hughes, MD, a health data researcher and professor of medicine at Yale University.nn

Click Here To Read More

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Source: www.ahima.org; Mary Butler; February 11, 2015.