Top 5 Medical Billing & Healthcare Trends Articles

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With the start of the new year, the staff at ABCS RCM are taking pause and reflecting on the year that was 2018.

Our regular news articles focus on medical billing topics and other trends in the healthcare industry. In the spirit of the new year, here are 5 of the most viewed articles from the previous year. A few of articles were first published in 2017, but they are still popular. The rankings were generated through the use of Google Analytics.

Here are the top 5 most popular news articles from 2018. They are listed below in order of popularity.

[1] Preventing Denied Claims:

Regardless of a healthcare provider’s medical specialty, denied claims are a problem. If these are left unchecked, a medical practices or healthcare facility can find their cash flow greatly restricted.

3 Ways to Prevent Denied Claims

[2] The growth of value-based strategies in healthcare.

Debates about how to create value in the healthcare industry are seen as one way to slow the rising cost of healthcare treatments in the United States. This trend is demonstrated by the challenge of simultaneously maximizing cost, quality and access. Other approaches utilize the use of data analytics to limit overtreatment. Similar strategies are evident in the push by CMS to expand value-based programs.

Creating Value in Health Care: The Iron Triangle

[3] Electronic Visit Verification (EVV) Federal Mandate

The legal mandate to expand the use of Electronic Visit Verification (EVV) for Medicaid waiver providers has created considerable debate. The I-DD community in many states are debating the merits of this federal mandate. DSPs and other caregivers are already underpaid which has created staff shortages in many states. From many caregivers and I-DD agencies, the EVV mandate is creating an additional obstacle.

Electronic Visit Verification, Medicaid and Ohio

[4] Common Medical Billing Modifiers:

Accurate medical billing and coding is a challenge. Whether healthcare professionals are using ICD-10, CPT or HCPCS. In addition, the correct use of modifiers is a requirement, or healthcare claims are quickly denied or rejected by insurance payers. This is true whether submitting claims for home health and behavioral health to radiology and cardiology.

ABCS – 7 common medical billing modifiers

[5] Fighting Takebacks By an Insurance Provider

Overpayment recovery, or takebacks, by an insurance payer is a request that no healthcare facility or clinic wants to experience. If medical claims are submitted properly to insurance providers the first time, a request for a takeback is less likely. However, unexpected takebacks can significantly disrupt a medical practice’s cash flow.

3 Steps For Successfully Appealing Takeback Request

These are the top five most viewed articles as of January 2019. In order to round out the list, here are the next five most popular articles for 2018. The articles are listed below in order of popularity.

Ohio Medicaid – Home Care Rate Increases

The Decline of Independent Healthcare Providers

Healthcare Industry Consolidation: Walmart-Humana Merger & Medicare Advantage Plans

UHC, Medicare Complaints, and Lawsuits

Ohio Medicaid Redesign and Behavioral Health Billing

ABCS RCM, as a company, provides experienced revenue cycle management solutions for a variety of medical specialties. In addition, we offer workforce management tools and account management services for Medicaid waiver providers/I-DD agencies. For additional questions about this topic or medical billing in general, please contact the staff at ABCS RCM.

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Denied Claims, Electronic Visit Verification, EVV, Takebacks