Source: https://myfcbilling.com/smart-medical-billing-tips/

Smart Medical Billing Tips

What does risk adjustment look like from a provider's perspective? In this episode of The Pulse, Lori Cox and Rhonda Buckholtz dive into the risk adjustment program and why it appears to be broken. They explore the challenges providers face when it comes to risk adjustment and explore potential solutions to these issues, including renegotiating contracts, additional education, and population-based care.

From Contracts to Coding: The Challenges of Risk Adjustment

On this episode of The Pulse, host Lori Cox teams up with guest Dawn Carter to discuss the crucial role of social determinants of health (SDOH) in shaping health outcomes. Did you know that SDOH account for a staggering 80 to 90% of health outcomes? Lori and Dawn examine the five major domains of SDOH. They also highlight the importance of appropriate screening tools, such as P.R.E.P.A.R.E., for improving documentation and effective data collection. With nearly 60% of individuals reporting that they have never discussed SDOH with their healthcare providers, Lori and Dawn emphasize the need to raise awareness and facilitate conversations around SDOH to ultimately drive better healthcare outcomes.

From Awareness to Action: Tackling Social Determinants of Health

As audits are increasing across the country, you need to know how to defend your reimbursements from payers and CMS. In this podcast of The Pulse, Lori Cox sits down with Michael Miscoe, an accomplished attorney, coding and software development professional, and former President of AAPC’s National Advisory Board. 

 

They discuss post-payment audits and clawbacks, dive into statistical samples, and share insights on defending coding accuracy, when to seek legal advice, and how to leverage third-party support if audited or fined.  

 

Listen now to: 
 

Explore the best approach for compliance plans, especially for smaller physician practices. 

Uncover the complexities of auditing medical claims, including identifying and correcting errors in E/M services. 

Discover distinctions between federal healthcare program claims and non-federal claims, unraveling the obligations triggered by potential incorrect payments.

Tackling Post-Payment Audits

Healthcare professionals are under increasing pressure to do more with less. Enter AI — a powerful tool designed to ease documentation burdens and improve coding accuracy. In this episode of The Pulse, Dr. Will Morris, Chief Medical Officer at Ambience Healthcare, discusses how AI is: 

Reducing provider burnout by streamlining clinical documentation. 
Improving coding accuracy for better revenue cycle outcomes. 
Supporting, not replacing healthcare teams.  

Whether you're in CDI, coding, or revenue cycle management, this episode offers insights on how AI can elevate your work. 


Do More with Less, Using AI

QueueLogix serves healthcare operators of all sizes. Our mission is ensuring you are paid accurately and promptly for the care you deliver. We offer medical billing, coding and compliance solutions across various specialties. Get a free practice evaluation and find out what opportunities may be present in your operation.

Visit Here: https://queuelogix.com/

Coding Compliance Solutions for Healthcare Professionals | QueueLogix

QueueLogix works as a professional medical billing audit services company. Medical billing and coding is complex work full of pitfalls for error, calling for vigilant oversight. Therefore, our medical coding audit and compliance services provide this monitoring, serving as a safety net that preserves the integrity of the entire medical claims billing process.

Visit Here: https://queuelogix.com/medical-billing-audit/

Medical Coding Audit Services at QueueLogix

QueueLogix provides medical coding, billing and compliance solutions for healthcare operators. We exist to ensure you get paid accurately and compliantly for the care you deliver.

The Pulse by AAPC examines the business of healthcare to help simplify the challenges faced by revenue cycle management experts.

New tracks tagged #medical coding