Inside Angle

From 3M Health Information Systems

Topic: Revenue Cycle

How will regulatory changes and new payment models impact your organization’s financial health? Our revenue cycle analysts share their perspectives.

A fix for persistent staffing challenges

July 13th, 2018 / By Kristine Daynes

Roughly 40 percent of healthcare financial leaders say their organizations lack in-house expertise and staffing for extremely important activities, such as managing new regulations and payment models. The gaps put […]

Transparency in healthcare pricing: It’s time

June 20th, 2018 / By Barbara Aubry, RN

In my last blog, I commented on being overcharged by my PBM for a medication that had been removed from their formulary – allegedly because the FDA pulled some old […]

When hospital-acquired conditions (HACs) hit close to home

May 30th, 2018 / By Steve Cantwell

Late one night this April, my good friend and work associate finds it so difficult to breathe she wakes her husband to drive her to Emergency. One day she’s on […]

Launching the Inside Angle Podcast: Discussions with healthcare thought leaders and innovators

February 14th, 2018 / By L. Gordon Moore, MD

One of the best parts of my job is the opportunity to interact with thought leaders and innovators from across the spectrum of healthcare delivery in the U.S. Given the […]

Mammograms and Modifier 52

February 12th, 2018 / By Barbara Aubry, RN

In late December 2017, I was asked by a colleague for my opinion on a customer’s inquiry about modifier 52 and its use in mammograms. CPT® modifier 52 represents a […]

Value-based payment means risk adjustment for effective revenue cycle management

May 3rd, 2017 / By Kristine Daynes

Value-based payment models are attracting attention for risk adjustment methodologies, especially HCC risk adjustment, which is used to calculate cost benchmarks for Medicare Advantage and other CMS payment models including […]

Article: A new focus on coding quality audits

With Sue Belley, RHIA

Sue Belley discusses ICD-10 and goes over some frequently asked questions about coding quality audits in this article in Health Management Technology.

2017 MOON update: Take this seriously

February 17th, 2017 / By Barbara Aubry, RN

Last year I wrote a blog about the new Medicare Outpatient Observation Notice or MOON, the latest in the CMS library of Beneficiary Notices. A lot of folks thought no […]

Observations from the corner of Medicare Advantage and MACRA

November 2nd, 2016 / By Clark Cameron, Gretchen Mills

In early October, CMS surprised everyone and published the highly anticipated Final Rule on MACRA well ahead of schedule. A number of blogs have since provided high-level summaries of the […]

Innovative payment models for complex populations

July 20th, 2016 / By Richard Fuller, MS, Norbert Goldfield, MD

In developing our classification tools we are continually called upon to make judgement calls on the relative clinical complexity of individuals and the interaction between comorbid chronic conditions on quality […]

The OIG turns their attention to Provider-Based Clinics

June 27th, 2016 / By Rebecca Caux-Harry

I have always wondered why the reimbursement for services provided at a Provider-Based Clinic (PBC) was higher (often more than 50 percent higher) than the same services provided at a […]

Leveling the playing field through site-neutral payment

April 18th, 2016 / By Richard Averill, MS, Richard Fuller, MS

Our recent article, “Implementing a Site-Neutral PPS,” published in the HFMA journal, highlights the potential for a reform currently making its way through the legislative process. The proposed legislation—referred to […]