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Value vs. Volume Based Care: 6 Critical Issues

Posted May 28, 2015

ID-10094648Medical practices, including radiologists and orthopedic surgeons, are facing numerous challenges in 2015 as the entire healthcare industry debates the benefits of volume-based care versus value-based care.  The current volume-based reimbursement model has faced controversy over the idea that doctors may be over-treating patients as a way to generate additional income or in an attempt to keep up with lowered reimbursements.  This has created an ethical and financial dilemma for practices who want to be reimbursed at a rate that can keep their doors open, but without over-treating patients or increasing the volume of patients to unmanageable levels.  The move from the volume-based to a value-based model is supposed to be a step toward resolving these concerns, but it also raises six critical issues when comparing the two models.

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healthcare Radiology Orthopedics

CMS Releases Meaningful Use Stage 3 Rule

Posted Apr 16, 2015

cms-meaningful-use-stage-3The Centers for Medicare and Medicaid Services (CMS) recently issued a 301 page proposed rule for establishing Stage 3 EHR Meaningful Use (MU) requirements.  If you are a practicing physician, including those in the specialties of radiology or orthopedics, the new rule applies to you.

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Radiology Orthopedics

PQRS Penalties in 2015

Posted Feb 26, 2015

2015_PQRS_PenaltiesOrthopedic providers may be subject to a reimbursement penalty on all claims submitted to Medicare for 2015. If you are an eligible professional (EP) that participates in the Physician Quality Reporting System (PQRS)  or a group practice participating in the Group Practice Reporting Option (GPRO), then you’re in danger of receiving a negative payment adjustment (penalty) of 1.5% on all covered services rendered this year. The 1.5% is to be deducted from the normal Medicare Physician Fee Schedule (MPFS) for services provided. Keep reading to find out if your practice will be affected by the adjustment.

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PQRS Health Information Services Orthopedics Practice Management Billing & Reimbursement

Converting your Top Ortho ICD9 Codes to ICD10

There are many orthopedic coding that will come with the switch from ICD-9 to ICD-10.This free guide will help you understand ICD-10, prepare for it, and give you the resources to guide your transition.

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How the 2015 CPT Coding Changes can effect your Orthopedic Practice

Posted Feb 26, 2015

orthopedic_practiceThe 2015 CPT coding changes will affect many different venues of healthcare with new and combined coding as well as removed codes. CPT 2015 code changes include: 134 revised, 143 deleted, 264 new as well as changes in guidelines. For orthopedic practices the new coding is already in effect, and needs to be adhered to immediately to ensure proper billing and payments.

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Health Information Services Orthopedics Practice Management

Impact of Payer Mix Shift on Orthopedic Practice Payments

Posted Nov 7, 2014

Impacts_of_Payer_Mix_ShiftIn order to maintain a healthy revenue stream, it is key that your practice has a well-balanced mix of payers. If your revenue stream seems to be sagging it could be that your payer mix has shifted in a negative direction. That is, you may have seen patients with coverage from lower, poor, or slow payers.  Here are some things you can do to address that situation.

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Health Information Services Medical Coding Orthopedics Billing & Reimbursement