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Find news and solutions for healthcare payers and providers. Recognize and avoid potential fraud, waste, and abuse scenarios. Real-time clinical claim editing are analyzed to maximize provider reimbursements.

Payers Use UCR Data to Drive Behavioral Health Outcomes

  • Margaret Klasa DC, APN BC
  • May 10, 2017
  • Comments
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Context's UCR data can help with Behavioral Health population health management. Behavioral Health issues compound the chronic condition scenario. The United States spends more on mental health and addiction than on any other medical condition including heart disease, trauma, and cancer.

population health, UCR, population management, behavioral health,

Payment Integrity and ACO Success

  • Margaret Klasa DC, APN BC
  • Apr 27, 2017
  • Comments
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An ACO must show that the care given to the patient has achieved its quality measures.

Reference Based Pricing, ACO,

CodeLink Pro ® 2017 Now Boasts Medical Necessity with Bill Editing

  • Margaret Klasa DC, APN BC
  • Apr 13, 2017
  • Comments
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Context4 Healthcare is proud to announce that its flagship CodeLink Pro® medical coding compliance solution CodeLink Pro® 2017 has been enhanced

Why Your EHR System Might Get You Audited: ICD-10 Dropdown Menu Fails

  • Margaret Klasa DC, APN BC
  • Mar 15, 2017
  • Comments
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Most EHR systems have drop-down menus in which ICD-10 code choices or search returns are in numerical order where say the fifth digit of 0 – indicating unspecified – is the first return or choice, while the more specific choices are farther down the list. Physicians are often picking the first code that appears in the drop-down menu therefore claims may be at risk due to continuous submission of unspecified diagnoses.

EHR coding, EHR coding issues, EHR coding risk, medical coding, ICD 10, ICD-10,

RAC Ramp Up for 2017

  • Margaret Klasa DC, APN BC
  • Feb 27, 2017
  • Comments
Marge Klasa - Context 4 - Resized

The five regional Recovery Audit Contractors (RACs) are ramping up their automated and complex reviews starting this month. The Centers for Medicare & Medicaid (CMS) Medicare Fee for Service (FFS) audit program awarded contracts in October 31, 2016 ....

healthcare, rac audit, healthcare compliance, program integrity, CMS audit, medicare, medicaid, FFS, FFS audit,

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