Blog
Understanding the Value of Value Based Care: Infrastructure
In this webinar, Understanding the Value of Value Based Care, Dan Fabius, DO, Consensus Health’s Chief Medical Informatics Officer, discusses the infrastructure recommended to support Value Based Care in your organization. At Consensus Health improving the health of...
Understanding the Value of Value Based Care
In a recent webinar, Dan Fabius, DO, Consensus Health’s Chief Medical Informatics Officer, dove into the basics behind Value Based Care — a form of reimbursement that ties payments for care delivery to the quality of care provided and rewards providers for both...
Creating a Trusting Partnership with Your Physician
The pandemic has created a new era in healthcare for both patients and physicians alike. Many of you have discovered abundant value in having your own personal physician and their office staff working diligently to maintain a trusted relationship to improving your...
Doctors in the Media: Abiding by HIPAA
In today’s digital age, it’s important to stay apprised of the rules and regulations surrounding providers and patients. A recent case in Connecticut serves as a good reminder of the rules set forth in the Health Insurance and Portability Act (HIPAA), which prohibits...
Building Direct-to-Employer Programs
The cost of healthcare has become a burden on employers. As a result, employers are looking for ways to: Increase the quality and efficiency of medical services Eliminate the healthcare middlemen or payers These two goals have led employers to establish direct...
Data Exchange Standards: Fast Healthcare Interoperability Resources (FHIR) & Blockchain
The Centers for Medicare and Medicaid Services (CMS) now supports improved health care interoperability efforts through applications that enable a data exchange between two disparate computer systems. One type of application programming interface (API) or data...
Health System-Owned Physician Practices Operating at a Loss
Some recent U.S. Department of Justice (DOJ) enforcement cases and settlements suggest that owning physician practices that are losing money may be a significant regulatory concern. The DOJ has suggested in the last few years that practice...
Getting Paid for Transitional Care Management (TCM)
Medicare adopted transitional care management (TCM) payment codes in 2013 to encourage clinicians to provide TCM services after beneficiaries were discharged to the community from medical facilities. As a result, Medicare spending on TCM services increased over 200...
Medicare Payment Advisory Commission (MEDPAC) Reimbursement of Evaluation & Management Codes
MEDPAC recently issued a report to Congress. It reviewed the reimbursement levels for office-based E/M codes versus procedural codes. The commission recommended a significant increase in the reimbursement of E/M codes. The increase ranged from 5% to 30% as a pay...
The Provider’s Role in Risk Adjustment Coding
Physicians must code diagnoses properly to succeed under Medicare & other value-based contracts Each year, CMS sets cost benchmarks for every Medicare member, based on the patients’ diagnoses during the prior year. But what if the physician hasn’t reported their...