Billing and Collections

For Medicare Advantage audits, there must be evidence in the medical documentation to support the billing codes, says David Lareau, CEO of Medicomp Systems.

The Medicare Advantage Risk Adjustment Validation final rule has ramped up compliance pressure against overcoding, says Dr. Calum Yacoubian, director of healthcare strategy at IQVIA.  

The challenge is the administrative burden on providers because there are no agreed-upon standards and measures, say Inovalon SVPs Kristopher Volrath and Karly Rowe.

Medicare, through CPT code development, sets the lead for how digital health gets paid, says Brian Scarpelli, executive director of the Connected Health Initiative.

This March 15-17 join host Kate Milliken on HIMSS.tv as she features keynotes, sponsor interviews and exclusive HIMSS22 Digital events. Follow HFN's HIMSS22 coverage all that week.

Hospitals can get paid up-front, according to Ben Simmons, VP of insurance at Gravie.  

Ali Abi Raad, country manager for Middle East & India at InterSystems, compares a cloud-hosted EMR solution versus a regular EMR.

This week's top stories include Cerner mandating that all U.S. employees be vaccinated by Dec. 8 as David Feinberg takes the reins as CEO, and digital musculoskeletal care company SWORD Health acquiring wearable maker Vigilant Technologies.

AccessOne CEO Mark Spinner says as health systems face revenue cycle challenges due to COVID-19, delivering "patient-friendly" payment options is one key to maintaining margins.

Availity is working with providers to bill COVID-19 encounters, says CEO Russ Thomas.