Billers
Established in 1996, HIPAA standards addressing major transaction types in the revenue cycle were not enough to achieve industry Administrative Simplification. Currently, less than one-half of medical claim reimbursements are made electronically. The Affordable Care Act (ACA) is pushing for transformation by implementing compliance initiatives including the mandated 5010 and Healthcare Operating Rules for EFT & ERA. These are driven by CAQH-CORE (The Council for Affordable Quality Healthcare – Committee on Operating Rules for Information Exchange).
Read MoreFormer Health and Human Services Secretary and Governor of Wisconsin, Tommy Thompson is interviewed by healthcare payments expert, Mark Brousseau, President of Brousseau & Associates in Q&A Session #12. Gov. Thompson talks about how administrative simplification should move forward within the healthcare industry. Currently healthcare is behind the curve of adoption compared to other industries including many banking applications and insurance companies.
Read MoreFormer Health and Human Services Secretary and Governor of Wisconsin, Tommy Thompson is interviewed by healthcare payments expert, Mark Brousseau, President of Brousseau & Associates in Q&A Session #10. Gov. Thompson talks about the role of banks in automating healthcare payments. Healthcare expenditures are 20% of the GDP, so banks should want to lead the industry in order to maximize the revenue opportunities.
Read MoreAdministrative costs are a major contributor to the healthcare industry’s runaway costs. The industry spends $100 million annually to manage claims processes alone – much of it tied to costly, inefficient and error-prone paper-based processes. A major culprit of all this operational inefficiency is the delivery of payments and explanation of benefits (EOB) information, which arrive as paper most of the time, according to the McKinsey report, “Overhauling the U.S. Healthcare Payment System”.
Read MorePractice management (PMS) software runs the business side of healthcare, from scheduling patients to billing to generating monthly reports. Unlike with electronic health records (EHRs), selecting and overseeing a PM system isn’t typically the physician’s domain. In a large practice, it typically falls on the office manager’s or IT manager’s shoulders.
Read MoreFormer Health and Human Services Secretary and Governor of Wisconsin, Tommy Thompson is interviewed by healthcare payments expert, Mark Brousseau, President of Brousseau & Associates in Q&A Session #6. ICD-10 is a diagnostic coding system implemented by the World Health Organization (WHO) in 1993 to replace ICD-9, which was developed by WHO in the 1970s. ICD-10 is in almost every country in the world, except the United States. When we hear “ICD-10” in the United States, it usually refers to the U.S. clinical modification of ICD-10: ICD-10-CM. This code set is scheduled to replace ICD-9-CM, our current U.S. diagnostic code set, on October 1, 2014.
Read MoreFormer Health and Human Services Secretary and Governor of Wisconsin, Tommy Thompson is interviewed by healthcare payments expert, Mark Brousseau, President of Brousseau & Associates in Q&A Session #5. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the Secretary of the U.S. Department of Health and Human Services (HHS) to develop regulations protecting the privacy and security of certain health information. To fulfill this requirement, HHS published what are commonly known as the HIPAA Privacy Rule and the HIPAA Security Rule.
Read MoreFormer Health and Human Services Secretary and Governor of Wisconsin, Tommy Thompson is interviewed by healthcare payments expert, Mark Brousseau, President of Brousseau & Associates in Q&A Session #4. Gov. Thompson talks about how patient responsibility may increase out of pocket expenses for the individual. If the end result is not “extreme”, this will be a positive influencer to the healthcare process and reduce excessive procedures, therein reducing costs within the process because there will be less denials.
Read MoreFormer Health and Human Services Secretary and Governor of Wisconsin, Tommy Thompson is interviewed by healthcare payments expert, Mark Brousseau, President of Brousseau & Associates in Q&A Session #3. In this interview, Gov. Thompson talks about the impact of Accountable Care Organization (ACOs). ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.
Read MoreIn the first Q&A interview, Gov. Thompson talks about the state of the healthcare industry, summarizing what’s right and what’s wrong. Relating to the changes required with the Affordable Care Act (ACA), many of the rules and regulations are assembled by administrators and bureaucrats of HHS.
Read More