Janine Mothershed CPC,CPC-I

We have to do better than this for both our providers and our patients. Removing documentation burden from providers isn't just good for them, it is good business sense in all the ways that matter...clinical outcomes, patient safety, availability and satisfaction. If this is an area of focus for your organization, our virtual documentation solutions are an effective and cost efficient way to move this needle. Documentation does not have to get in the way of patient care. From the article: The TrendBurden Pulse Survey from AMIA (American Medical Informatics Association)'s 25x5 Task Force was designed to collect data and insights on how clinicians are experiencing documentation burden and charting within electronic health record workflows. This April, AMIA received more than 1,250 responses from healthcare professionals – physicians/surgeons (36%), registered nurses (25%), licensed social workers, educators and others – across 49 states and the District of Columbia. Across all respondents, nearly 75% of respondents said "the time required for documentation impedes patient care," says AMIA.

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As a healthcare provider, you should be able to focus on your patients-- not worry about credentialing and other administrative work. We can help make that happen. Altruis can ensure physicians and facilities are properly credentialed and registered with insurance companies and state agencies for the services they provide. Our team of experts is trained to manage the entire credentialing process timely and accurately, relieving the burden on your practice. Learn about our Medical Credentialing services and how we can give you crucial time back: https://bit.ly/3Pustx5 #MedicalCredentialing #Credentialing #Billing #MedicalBills #FQHC #Healthcare #MedicalBilling #MedicalCoding #Medicaid #Medicare #HealthcareBilling #RCM #RevenueCycleManagement

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Problem: Too many claims being held or written off, and aging AR is growing. How many practices have experienced this with their EHR platform? RCM programs that submit claims and provide minimal follow-up on those that are not paid for various reasons (additional documentation required, different code or modifier needed, etc.) cost physicians revenue that they should be receiving. Solution: KollectMD can access your existing EHR platform to analyze your aging AR to determine which claims are still eligible for payment and resubmit them, working with your office staff to ensure all necessary information is included prior to resubmission. We can also run custom denial reports on a regular basis and review it with you so that errors can be corrected for future claims. Our team is committed to making sure you receive the revenue you are entitled to. If you want to learn more about how our services can improve the operation of your practice, contact us at info@kollectmd.com. #revenuecyclemanagement #medicalbilling #medicalcoding #medicalbillingandcoding #medicalpracticemanagement

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**Attention LTC Professionals! QIPP Update and M&A Activity ** Many companies are strategically acquiring new long-term care (LTC) facilities to capitalize on a significant funding increase in a government program called the Quality Incentive Payment Program (QIPP). Here's the breakdown: QIPP launched in 2017, but 2024/2025 is seeing a MAJOR funding boost at the state level! ⏫ This program incentivizes LTC facilities to improve resident care through performance-based reimbursements. What does this mean for LTC communities? Financial Incentives Galore! Facilities exceeding performance measures can receive bonus payments or DOUBLED daily resident rates (think $13/day to $23/day!)! Increased Revenue Potential. These financial boosts can add significantly to a facility's yearly income, supporting quality improvement initiatives like staff training and enhanced patient programs. Keep in mind: Different states may have variations of QIPP with unique criteria. Do your research! This program seems to target improvement within the industry, incentivizing better care for residents. A positive step forward! M&A and Technology: A Match Made in Heaven (or at Least Business) When M&A's happen in the long term living facilities, technology integration can often be overlooked in the chaos. Partnering with Pioneer Technology provides an expert in seamlessly integrating and transferring technology to ensure a painless migration, minimizing disruption to patient care and staff routine. Contact our team today to learn more about IT needs for Long Term Care facilities! ➡️ support@pioneerit.com #LTC #QIPP #Healthcare #QualityImprovement #GovernmentFunding #SeniorLiving #LongTermCarePolicy #SeniorCare

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Exclusive Update on Medicare Coverage Determination for Special Stains and IHC Stains by Palmetto and WPS Effective July 14, 2024, two Medicare Administrative Contractors (MACs), Palmetto and WPS, have finalized their Local Coverage Determinations (LCDs) concerning medical necessity guidelines for special stains and immunohistochemical (IHC) stains. These determinations, LCD L36805 (WPS) and LCD L35922 (Palmetto), provide clear and stringent criteria under which Medicare will cover these stains. Key Points of the LCDs: *Conditions for Coverage: 1.Medical Necessity: The special stains and IHC stains must be medically necessary to ensure a complete and accurate diagnosis is reported to the treating physician. 2.Communication and Utilization: The results of the stains must be communicated to and used by the treating physician in the patient's treatment plan. 3.Documentation: The pathologist must document in the pathology report the rationale for performing the additional stains. *Prohibitions and Requirements: -A statement in the pathology report that merely says "IHC confirms the diagnosis" will not be considered sufficient for coverage. -The necessity of the stains must be justified with specific documentation within the surgical pathology report, detailing why the stains were performed and the results obtained. *Specifics of the LCD L36805 (WPS): -This policy emphasizes that reflex templates or pre-orders for special stains and IHC stains before reviewing the routine hematoxylin and eosin (H&E) stain by the pathologist are not considered reasonable and necessary. -Only the pathologist may determine the need for special stains after reviewing the routine H&E stain. -Exceptions include recognized standards of care in certain biopsies and the suspicion of infectious diseases. *Specifics of the LCD L35922 (Palmetto): -Like WPS, Palmetto’s policy requires detailed documentation of the medical necessity for special stains or IHC studies and their results in the pathology report. -The policy delineates scenarios where over-utilization or incorrect billing of these stains may occur, such as the use of pre-orders for special stains without prior review of the H&E stain. Implications for Pathologists and Healthcare Providers These determinations highlight the critical role of pathologists in ensuring that the use of special stains and IHC stains is both necessary and properly documented. Healthcare providers must ensure compliance with these guidelines to secure Medicare coverage for these diagnostic tests. Proper documentation and communication with treating physicians are paramount to adhere to these new standards. For further details, you can review the complete LCDs on the CMS website using the following LCD IDs: L36805 and L35922. #Medicare #Healthcare #Pathology #MedicalNecessity #IHCStains #SpecialStains #Palmetto #WPS

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Are you inundating your patients with messages❓ Are they receiving the right information at the right time❓ Download "Your Guide to Governance," a comprehensive resource designed to help you effectively manage your patient communications strategy enterprise-wide. 𝐓𝐡𝐢𝐬 𝐠𝐮𝐢𝐝𝐞 𝐢𝐧𝐜𝐥𝐮𝐝𝐞𝐬 𝟓 𝐛𝐞𝐬𝐭 𝐩𝐫𝐚𝐜𝐭𝐢𝐜𝐞𝐬 𝐭𝐨 𝐡𝐞𝐥𝐩 𝐲𝐨𝐮: ✅ Understand the risks of over-messaging and digital fatigue ✅ Break down silos and establish a governance committee ✅ Measure, iterate, and improve your enterprise-wide communication strategy ➡️ Download the full governance guide and workbook here » https://lnkd.in/gGHjjExa #healthcare #patientexperience #digitalhealth #medtech #healthtech

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Impact of Policy Changes on SNF Billing Let's know about how recent policy changes affect Skilled Nursing Facility (SNF) billing: 🔹Understand new reimbursement rules. 🔹Adapt to updated documentation requirements. 🔹Navigate changes in Medicare/Medicaid guidelines. 🔹Prepare for potential shifts in billing procedures. Ready to navigate these changes effectively? Let's discuss how they impact SNF billing practices today! Know more: https://bit.ly/452uyGo For more insights, Contact 24/7 Medical Billing Services for a free consultation at  888-502-0537 / info@247medicalbillingservices.com. #SNFBilling #HealthcarePolicy #MedicalBilling #MedicareBilling #HealthcareRegulations #SNFReimbursement #HealthcareFinance #BillingCompliance #MedicalBilling #LongTermCare #SkilledNursingFacilities #BillingUpdates #ReimbursementRates #SkilledNursingFacilityBilling #247MedicalBillingServices

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RevCure understands the importance of accurate and complete clinical documentation.  Our Physician CDI Program Includes: ✓ Clinical Documentation Assessment ✓ Physician Education and Training ✓ Documentation Improvement Strategies ✓ Ongoing Support and Monitoring Our CDI Analytics Services Include: ✓ Performance Reporting ✓ Data Visualization ✓ Trend Analysis ✓ Predictive Analytics #revcure #revenuecyclemanagement #healthcareconsulting

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System modernization isn't just a trend, it's a necessity. Let's talk about the people side of change! 💡 🔶 Needs analysis 🔶 Readiness assessment 🔶 Communication planning 🔶 Stakeholder management #BrilliantPossibilities #ChangeManagement #HealthIT #Medicaid

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Is your urgent care missing patient calls? 📞 Learn how friction points like missed calls, scheduling issues, and slow registration processes impact patient loyalty and your bottom line. Discover how to improve the patient journey and keep families coming back. #UrgentCare #TeleCloud https://lnkd.in/ef3Xw_rK

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Health literacy is vital for advancing Medicaid equity. Center for Health Care Strategies latest resource equips healthcare professionals with practical strategies to improve how they communicate with Medicaid members, ensuring patients understand and access the care they deserve. Strengthening these communication efforts helps break down barriers, fosters trust, and leads to more equitable health outcomes. Explore these insights to enhance patient engagement and drive better results in your community.

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Don't be left out! The Medicare Senior Summit will be a full 3 days of Keynote Speakers, CE Classes, Panel Discussions, exhibits and lots more! Get first hand information for the 2025 new rules about Medicare. Click this link to register: https://lnkd.in/gZ_fUHU3 #seniorsummit #Medicare2024 #medicareadvantage #Medicare #medicareinsurance #insuranceagency #insuranceagents #insurancebroker #MedicareSupplementPlans #medicareagents

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Don't be left out! The Medicare Senior Summit will be a full 3 days of Keynote Speakers, CE Classes, Panel Discussions, exhibits and lots more! Get first hand information for the 2025 new rules about Medicare. Click this link to register: https://lnkd.in/gZ_fUHU3 #seniorsummit #Medicare2024 #medicareadvantage #Medicare #medicareinsurance #insuranceagency #insuranceagents #insurancebroker #MedicareSupplementPlans #medicareagents

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Medicare has made a change to how it processes inpatient denials. Effective July 1, 2024, DMEPOS that deny due to the patient being inpatient will now deny as Contractual Obligation instead of Patient Responsibility. This means that suppliers will only be able to bill the patient for these claim denials if a valid ABN was obtained on or prior to delivery of the item. #oandp #insidetheindustry #inpatientdenials #whatyouneedtoknow #industrypsa

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📢 SimiTree proudly supported Eden Health (Home Health, Hospice, Home Care)'s acquisition of A Plus Hospice Care in Nevada. SimiTree’s comprehensive services included clinical/operational due diligence, financial due diligence, and Quality of Earnings Analysis. Another successful step in expanding access to essential healthcare services! Read the full release now: https://bit.ly/3AQCSzB #Healthcare #MA #Hospice

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🔍 Avoid Common Billing Errors That Trigger Claim Denials 🔍 Running a medical practice isn’t easy. Between patient care and daily operations, claim denials should be the least of your worries. Yet, they often happen due to simple, preventable billing errors. At Sosa Practice Partners, we know how costly denials can be—and we’re here to help! Here are 7 common errors and ways to prevent them: 1️⃣ Incorrect Patient Information 👉 Always verify patient details at check-in and submission. 2️⃣ Outdated Insurance Coverage 👉 Use real-time insurance verification for every visit. 3️⃣ Coding Errors 👉 Stay updated on medical coding guidelines and invest in team training. 4️⃣ Incomplete Documentation 👉 Develop a checklist for required documents to support claims. 5️⃣ Missed Filing Deadlines 👉 Track payer-specific deadlines and use software reminders. 6️⃣ Missing Prior Authorizations 👉 Complete the authorization process before providing services. 7️⃣ Improper Modifier Usage 👉 Keep a reference guide handy and train staff on proper modifier use. ✨ Final Thought: Reducing denials isn’t just about fixing errors—it’s about ensuring your practice gets paid faster. Implementing these strategies can significantly improve your revenue cycle. Need help optimizing your billing process? That’s what we do! 💼 At Sosa Practice Partners, we specialize in medical billing, credentialing, and revenue cycle management. Let us help you reduce denials and streamline your workflow. 📩 Contact us today! www.sosapartners.com #MedicalBilling #RevenueCycleManagement #ClaimDenials #HealthcareBilling #SosaPracticePartners #MedicalPracticeManagement

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Are you participating in the #healthIT summer reading program? It includes the following: ✅ Office of the National Coordinator for Health Information Technology (ONC) HTI-2 Proposed Rule ✅ Centers for Medicare & Medicaid Services CY25 Medicare Physician Fee Schedule (MPFS) Proposed Rule ✅ Centers for Medicare & Medicaid Services CY25 Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System Proposed Rule. Happy reading! 📚☀ #interoperability #healthIT #HTI2 #HIE #publichealth

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