Healthcare Industry
Administrative 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 MoreHave you heard the news? Again! ICD-10 is pushed back another year for implementation. Behind the controversy of the Affordable Care Act (ACA) was a tsunami brewing within the healthcare industry. Many were concerned about the overhead and conversion costs, so pressure was building as the deadline was lurking in October 2014. It might have been another “Y2K”, in that proper planning and execution would have mitigated the risks and made the transition more like a little storm rather than a tsunami… but we will never know for 2014.
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 #8. Healthcare providers are finding the current business environment to be very challenging from a financial standpoint. Major market factors such as the Affordable Care Act (ACA), a slow growth economy and consumerism are squeezing the bottom line of providers.
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 #7. There are many pain points in the healthcare industry today. Many of them are due to the uncertainties of the future, which are tied to a general confusion on the implications of new regulations. Healthcare providers, payers and other players are all affected.
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 MoreI just received my notification email from NEACH (New England ACH) to download the 2014 NACHA Operating Rules & Guidelines. I have to say, this is good reading! As you may now, “the 2014 NACHA Operating Rules and Guidelines is the definitive source for information about the exchange and settlement of transactions through the ACH Network. The NACHA Operating Rules provide the legal framework for the ACH Network in simple, clear and consistent language. The NACHA Operating Guidelines contain complete discussions of each ACH Network participant type and its role and obligations, as well as detailed overviews of Standard Entry Class Codes.
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