President's Message
As I put the finishing touches on this article, yet another healthcare cyberattack hit one of my clients and shut them down. McLaren Health Care, based in Michigan, was under attack yet again. When they were attacked in 2023, 2.2 million patient records were compromised.
HBMA Members SOUND OFF! on industry topics
TOPIC: How are you addressing credentialing and appeal delays from insurance companies?
From Inception to Current Day
By Holly Louie, RN, Chair
Soon after HBMA's founding, a key group of charter members who understood the magnitude of the influence that the HCFA had over our industry, recognized the importance of a more organized and official representation of our association, and established the Government Relations Committee.
Around the HBMA
Photo wrap-up from HBMA's 2024 RCM Fall Conference in Austin, September 17-29.
The Benefits and Potential Challenges
The growing pressure for cost reduction and revenue cycle efficiency in healthcare is driving an increased demand for outsourcing, with 83% of health systems now outsourcing at least one component of the revenue cycle. Offshoring continues to be a more acceptable and necessary solution.
A Negotiator's Perspective
Many of us have limited exposure to the negotiations between providers and Managed Care Organizations (MCOs) that take place behind closed doors. The extent of our knowledge typically consists of a general introduction by our employer to the policy they selected.
Feature Story
This article examines and promotes the benefits of heart-led behaviors for personal and professional development, its relation to producing work at an optimal level, and how managers and people in supervisory roles can utilize these behaviors to establish a foundation rooted in integrity, uncolored opportunity, and positive support and direction.
Feature Story
The Medicare Merit-based Incentive Payment System (MIPS) is well-intentioned, but its reporting requirements are burdensome to physician practices and often appear to be clinically irrelevant, with a focus on checking boxes rather than improving care.
Feature Story
By Randi Tapio, MBA, CMRS, CCCES, CPCS, CHM, CHBP
In the fast-paced world of healthcare, providers often find themselves juggling various administrative tasks while striving to deliver top-quality patient care. Among these crucial tasks, credentialing and payor contracting play a vital role in a provider’s financial success and ability to offer their services to different patient populations.
Government Affairs
As we approach the end of the year, Congress and federal agencies will be busy advancing new legislation and regulations. The pace of new policy activities will increase the closer we get to the end of the year.
Compliance Issues
In today’s digital age, managing online feedback has become critical in all sectors of the healthcare industry, including revenue cycle management (RCM) companies. As patients increasingly turn to online platforms to share their experiences, RCM companies must consider how to proactively, rather than reactively, handle online reviews and comments.
the tech guy
In today's digital world, scams are becoming more sophisticated and common. One scam that has been gaining popularity is QR code phishing, also known as “Quishing.” Quick Response, known as QR codes, which are commonly used for their quick and easy access to information, can unfortunately be manipulated by criminals to trick unsuspecting individuals.
Coding Corner
By Melody W. Mulaik, MSHS, RCC, RCC-IR, CPC, COC
The HCPCS is comprised of two different code sets: Level I consists of CPT® codes, maintained by the AMA, discussed in this column earlier this year, and Level II codes, which are comprised of alphanumeric HCPCS codes and maintained by the DHHS.
From the Road
I was rereading the booklet written in 1988 by Pritchett and Pound entitled Business as Unusual. Its premise is how to survive in an ever-changing environment like our current medical billing marketplace. It is hard to believe it was published over 35 years ago, but it could not be more relevant, considering what we are facing today.
