Medicare Advantage Plans Under the FWA Microscope
HEALTHCARE is again the most popular topic for the past few weeks. Even friends that don’t know much about the industry have asked: what’s going on with Medicare? Apparently, recent allegations of high dollar medical fraud have raised concerns about Medicare Advantage Plans and Payment Integrity. One law firm pointed out that this is just the start. “DOJ’s big settlement — $16.7 million for risk adjustment “upcoding” ...
Payers Use UCR Data to Drive Behavioral Health Outcomes
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.
Payment Integrity and ACO Success
An ACO must show that the care given to the patient has achieved its quality measures.
CodeLink Pro ® 2017 Now Boasts Medical Necessity with Bill Editing
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
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.