How Hospitals, EDs Effectively Code Social Determinants of Health

Published: Thu, 07/28/22

How Hospitals, EDs Effectively Code Social Determinants of Health

In 2021, the Centers for Medicare & Medicaid Services (CMS) issued guidance to emphasize the importance of social, economic, and environmental factors that can affect the health outcomes of disadvantaged populations. Known collectively as social determinants of health (SDOH), they often have a more significant impact on the health outcomes of patients than the actual delivery of health services. These...

Updates to the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2023

It’s time to review the Official Guidelines for Coding and Reporting for fiscal year 2023. These take effect Oct. 1, 2022, and reflect the new ICD-10-CM codes as of that date. The changes are bolded so that the reader can distinguish what is newly added or edited.

Special Bulletin: CMS Issues Proposed Rule for Physician Fee Schedule

The proposed rule includes expansions to the Physician Payment Schedule as well as a focus on access to high-quality care. The Calendar Year 2023 Physician Fee Schedule (PFS) proposed rule, released July 7 by the Centers for Medicare & Medicaid Services (CMS), provides an expansion in access to services, especially in rural areas. The expansion includes behavioral health, cancer screenings, dentistry, and funding for Accountable Care Organizations (ACOs).

AMA: Payers not following prior authorization reforms they agreed to in 2018

A new survey of physicians finds they are still facing burdens meeting prior authorization requirements despite a voluntary 2018 agreement among payer groups to reform the practice. The survey was released Tuesday by the AMA and comes amid criticism over prior authorization denials and requests in the Medicare Advantage space. The AMA spoke...

How Health Systems Improve Patient Collections

The rising cost of healthcare in the United States has left consumers feeling lost and overwhelmed. High deductible healthcare plans, co-pays, and out-of-pocket medical expenses have all contributed the emergence of healthcare consumerism, which is the pursuit of making healthcare services more efficient and cost-effective by putting the purchasing powering in the hands of the patient. Because of this...

AHA Comment Letter to CMS on the Provider Complaints Submission Process under the No Surprises Act

On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — as well as the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) thanks you for the opportunity to comment on the forms providers may use to file complaints with the Centers for Medicare & Medicaid...

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