News

Compliance is a big part of the risk adjustment HCC. Everyone is welcoming the New Year, and I am among them. This is a good time to take a look at some basics that make up the Medicare Advantage (MA) Risk Adjustment (RA) and Hierarchical Condition Category (HCC) model. Those…
Not all words that can be mapped within a health record to a diagnosis code are clinical documentation or reportable.   As we start 2021, it seems like a good time to get back to basics. Something that has been on my mind recently is this: do we, health information management…
Burnout in healthcare professionals, physicians in particular, was high pre-COVID. We are hearing stories every day about healthcare delivery professionals being caught up in the stress of the intense, long hours necessary to deliver care to COVID-19 patients. There have been an ebb and flow in the intensity and the…
The federal holiday honoring King is annually held on the third Monday in January. The executive body of a prominent nationwide healthcare organization has issued a formal apology for what it described as a history of racism, the announcement coinciding with the federal holiday honoring the life and work of…
In a stunning move, the U.S. Department of Health and Human Services (HHS) just announced that it is eliminating the need for providers to have a special waiver from the Drug Enforcement Administration (DEA) to prescribe medication-assisted treatment (MAT) for opioid use disorder. Approved by the Food and Drug Administration…
The principles focus on continuous improvement. There have been numerous articles and other materials written promoting the material benefits of implementing some if not all of Toyota’s 14 principles, first outlined by the auto manufacturer in The Toyota Way, published in 2001. These principles have been referred to as “a…
The conversion factor was increased twice in one week. The Centers for Medicare & Medicaid Services  (CMS), in a rare move, recently raised the  conversion factor (CF) twice in one week, resulting in an adjustment of approximately $34.89 for 2021. The action by CMS marked a last-minute slight increase to…
The “S” is used to identify the subjective requirements of the documentation. While conducting a 2021 evaluation and management (E&M) physician training event for a client, like right in the middle of the session, I had an epiphany. Now, maybe you have already had it as well, but I thought,…