Bhavya Bhandari’s Post

Physicians are grappling with increased competition and lower reimbursements, with 23% reporting decreased practice income since 2023. To address these challenges, practices are adding patient services and non-physician staff, according to MedCentral's survey of 864 U.S. physicians. Key issues include administrative burdens (66%), reimbursement (57%), and staffing shortages (56%). Most physicians (66%) aren't using AI, though those who do find it aids in documentation, billing, and diagnosis. Practices are shifting to models like direct primary care (DPC) and concierge services, with 17% incorporating urgent care. Additionally, 44% of physicians have medical side gigs for extra income. The survey highlights new barriers in drug prescribing due to lack of patient access and drug shortages. In response, 56% of practices have added non-physician practitioners, and 55% have integrated ancillary services, telemedicine, upgraded patient portals, and flexible scheduling. These changes aim to enhance patient care and practice efficiency, as noted by Dr. Joann Manson. Our team of professionals can streamline your processes by managing administrative tasks, implementing efficient scheduling, and integrating telemedicine and patient portals. We provide support in adding non-physician practitioners and ancillary services, ensuring enhanced patient care and operational efficiency. We are the One! #revenuecycle #revenuecyclemanagement #priorauthorization #medicalbilling #medicalcoding #healthcare #healthcaretechnology #accountsreceivables #denialmanagement #consulting #management #implementationpartner Medical Economics

As healthcare professionals, we understand the critical nature of medication reconciliation in patient care, especially during transitions between care settings. While this process often highlights the expertise of pharmacists, the integration of Electronic Health Records (EHRs) is pivotal to achieving optimal results. 📌 Key Takeaways: 1-Medication reconciliation ensures the accuracy of a patient’s medication list, reducing the risk of adverse drug events (ADEs) and unnecessary hospital readmissions. 2-Challenges such as incomplete protocols, lack of interoperability between systems, and poor communication between healthcare providers hinder its effectiveness. 3-Evidence shows that integrated EHR systems significantly enhance the reconciliation process by: Automating drug-allergy and duplicate-checks. Providing real-time updates on medication orders. Serving as a unified platform for communication among pharmacists, nurses, and physicians. 💡 Future Opportunities: 1-Improved training on EHR systems to streamline workflows. 2-Enhanced interoperability to bridge gaps between inpatient and outpatient settings. 3-Development of standardized protocols that incorporate EHR features for consistency across facilities. 4-The integration of EHR systems isn’t just a technological upgrade—it’s a transformative tool that supports pharmacists and clinicians in their mission to deliver safer and more effective care. Let’s embrace innovation and collaboration to prioritize patient safety and improve health outcomes! 🩺💻

Clinical Documentation Integrity Programs in the Spotlight Clinical Documentation Integrity (CDI) refers to the process of ensuring that healthcare records accurately reflect the clinical status and care provided to patients. It involves the thorough and accurate documentation of a patient's health status, treatments, procedures, and outcomes. The CDI profession plays a vital role in ensuring the integrity of the record. Documentation integrity refers to the accuracy and completeness of a document, such as a medical record, and its ability to represent what was created by its author without alteration. Payers are increasingly issuing denials, whether they be medical necessity, level of care downgrades, clinical validation, or DRG downgrades. While some denials are egregious, others are valid and cannot be appealed. After being heavily involved the past month in reviewing denials and providing feedback to physicians from a learning perspective, it is readily apparent that clinical documentation integrity professionals can play a major role in building and expanding upon present-day CDI processes. Let's start by recognizing the medical record as a communication tool, a repository for all physicians to document and chart patient care, serving as a means for physicians to tell and describe the patient story, capture their observations from the patient, record the patient's physical findings, tabulate and process the information gathered, and communicate in the form of diagnosis and plan of care. Overlay the notion of medical necessity for all care provisions which will be supported by complete and accurate documentation and communication of patient care. CDI can be the champion of transforming denials management to denials avoidance through a focus and commitment to working with physicians to achieve optimal practice preemptive denials avoidance documentation. Bear in mind that the only individual who can truly improve the integrity of the record is the physician through educational and guidance efforts of the CDI profession Reach out to me if you want to learn more about how to make a fundamental shift from reactive CDI to proactive CDI that drives better revenue cycle performance with less denials and more sustainable net patient revenue. #CDI, #CDIspotlight, #betterwaytoCDI #denialsavoidance, #fiscalhealthofhospital https://lnkd.in/eq-iQhaH

What is patient experience, and why does it matter? It matters because, as physicians, we are first and foremost patient advocates. Improving patient experience is seen as a key component of healthcare quality, as positive experiences are linked to better health outcomes, increased patient satisfaction, and higher levels of trust in healthcare providers. Patient experience refers to patients' interactions with the healthcare system, including their care from health plans, doctors, nurses, and staff in hospitals, physician practices, and other healthcare facilities. It encompasses several aspects: 1. Communication: This includes how effectively healthcare providers communicate with patients, listen to their concerns, and explain treatments and procedures. Good communication helps patients feel understood and involved in their care decisions. 2. Access to Care: Patient experience involves how easily patients can access medical care. This includes appointment availability, wait times, ease of scheduling, and how quickly patients can receive urgent care when needed. 3. Environment: The physical environment of healthcare settings, such as cleanliness, comfort, and privacy, also affects patient experience. A welcoming and well-maintained environment can positively influence a patient's perception of care. 4. Coordination of Care: This involves how well different healthcare providers work together to provide seamless and continuous care. Proper coordination can prevent gaps in care, reduce duplicate tests or procedures, and ensure that patients receive appropriate follow-up. 5. Emotional Support: Providing emotional support and addressing patients' fears and anxieties are crucial components of the patient experience. This includes empathetic care, mental health support, and helping patients manage the stress associated with illness and treatment. 6. Patient Involvement: Encouraging patients to be involved in their care decisions and respecting their preferences and values. Shared decision-making and involving patients in their treatment plans enhance their satisfaction and adherence to prescribed therapies. 7. Outcome and Recovery: Patients' experiences with the outcomes of their treatments and their recovery process, including pain management, rehabilitation, and follow-up care, are significant aspects of their overall experience.

🔍 Understanding CPT and ICD-10 Codes: A Key to Efficient Healthcare Management 🔍 In the complex world of healthcare, CPT (Current Procedural Terminology) and ICD-10 (International Classification of Diseases, 10th Revision) codes are essential tools for ensuring accurate and effective patient care. 🩺 CPT Codes: These codes, maintained by the American Medical Association, are used to describe medical, surgical, and diagnostic services. They help streamline billing, ensure uniformity across healthcare facilities, and facilitate the processing of insurance claims. 📊 ICD-10 Codes: Managed by the World Health Organization, ICD-10 codes classify diseases and health conditions. They provide detailed information on diagnoses and help in tracking disease prevalence, treatment outcomes, and overall public health trends. 🌟 Why It Matters: Proper use of CPT and ICD-10 codes not only improves patient care but also enhances operational efficiency, reduces errors, and ensures compliance with healthcare regulations. At MediFund Flow Solutions, we are dedicated to leveraging these coding systems to optimize healthcare delivery and support our clients in navigating the complexities of medical billing and coding. #Healthcare #MedicalCoding #CPTCodes #ICD10 #PatientCare #HealthcareManagement #MediFundFlowSolutions https://lnkd.in/dVY6PYdZ

Hospital Upcoding leads to billions in extra payments, Rand Study announces. A major question to ask is whether hospital upcoding identified by the study is truly overcoding or instead is it related to Hyperdocumentation perpetuated by the cottage industry that came to be as a result of the introduction of the MS-DRG system in 2008. Coders must follow the Official coding guidelines, and advice provided by the Coding Clinic and also must adhere to a strict Code of Ethics promulgated by AHIMA or AAPC. Can errors or oversights occur in coding? The answer is yes based on the application of coding rules and guidelines in the face of incomplete documentation in the chart. There are instances where coding may be in a "gray area" where one coder may arrive at a different principal diagnosis from another coder who reviews the same chart. Coding is an art and not a science. Consider that coding errors hover around 5% for IPPS inpatient claims under the CERT contractor Annual Improper Payment Supplmenta Data Report with the majority of improper payments associated with IPPS Part A claims associated with medical necessity and insufficient documentation. Consider that in most facilities clinical validation denials are associated with coding errors when in reality they are clinical denials based on physician documentation that potentially does not clinically support a diagnosis. CDI is best in the position to address concurrently in their chart review. Thank you Sharon Easterling for joining me on this podcast and sharing your thoughts and ideas about Overcoding as identified within this report. Every CDI must take note of the findings in this report and be proactive at their facilities to ensure their hospital does not exhibit patterns of aberrant documentation, coding, and billing that will invite outside payer scrutiny https://lnkd.in/eHu4HP4a #cdi, #overcoding, #randreport, #hyperdocumentation, #overqueries, #queriescausedenials https://lnkd.in/eXyTdmec

A Comprehensive Guide to 2024 ICD-10-CM Code Changes. Stay Updated: https://lnkd.in/gdKxr7-F #Allzonems #allzonemanagementservices #healthcare #ICD10 #codingchanges #medicalcoding #medicalcoders

Importance of Medical Records in the healthcare system.📝🌟 Medical records play a crucial role in the healthcare system. They are essential for providing high-quality care and ensuring patient safety. Here are several key points highlighting the importance of medical records: 🖋️ Continuity of Care Medical records provide a comprehensive history of a patient's health, including past illnesses, treatments, medications, allergies, and surgeries. This information is vital for healthcare providers to understand the patient's medical background and make informed decisions about current and future treatments. 🩺Accurate Diagnosis and Treatment Accurate and complete medical records help healthcare providers diagnose conditions more precisely and choose the most effective treatments. They can compare current symptoms with past health issues, track disease progression, and monitor the effectiveness of previous treatments. 🌟 Coordination Among Providers Medical records enable different healthcare providers to communicate and coordinate care effectively. This is especially important for patients who see multiple specialists or require complex, multidisciplinary treatment plans. It helps avoid duplication of tests and procedures, reducing unnecessary costs and potential risks to the patient. 📝Legal Documentation Medical records serve as legal documents that can be used in court to provide evidence of the care provided. They can protect both patients and healthcare providers in cases of medical malpractice or disputes over treatment. 📖Public Health and Research Aggregated medical records contribute to public health data and research. They help identify trends, track outbreaks, and develop new treatments and medical guidelines. Researchers can use anonymized medical records to study disease patterns, effectiveness of interventions, and overall population health. 🌟 Insurance and Billing Accurate medical records are essential for insurance claims and billing. They provide the necessary documentation to justify treatments and procedures, ensuring that healthcare providers are reimbursed appropriately and that patients are not overcharged. 📢Patient Empowerment When patients have access to their medical records, they are more informed about their health. This can lead to better health outcomes, as patients can actively participate in their care, understand their conditions, and adhere to treatment plans. ✍️Quality Improvement Healthcare organizations use medical records to monitor and improve the quality of care they provide. By analyzing data from medical records, they can identify areas for improvement, implement changes, and track the impact of those changes over time. #quality #qci

Enhance Patient Care & Boost Practice Revenue with Chronic Care Management (CCM) Physicians, are you looking to improve outcomes for your chronic care patients while simultaneously enhancing your practice’s revenue? Adopting a Chronic Care Management (CCM) program could be the transformative solution you need. Why Adopt CCM in Your Practice? • Improve Patient Outcomes: CCM services provide consistent, high-quality care to chronic patients, ensuring they stay on track with their treatment plans and have regular check-ins. Better care translates to healthier, more satisfied patients. • Increase Revenue Streams: Medicare’s CCM program offers generous reimbursements for the time and resources invested in managing chronic conditions. This service is reimbursable, generating an additional revenue stream for your practice without increasing in-office appointments. • Enhance Practice Efficiency: With a structured CCM program, your team can proactively manage chronic patients, preventing escalations, reducing emergency room visits, and improving overall healthcare costs. Our streamlined approach reduces the burden on your practice, allowing you to focus on what matters most—providing quality care. How We Can Help You Succeed with CCM Our CCM solutions are designed to integrate seamlessly into your practice, offering: • Automated Workflow Tools to support compliance with Medicare regulations. • Patient Engagement & Education to keep patients actively involved in their care. • Billing and Coding Support for accurate claims submission and maximized reimbursements. Ready to Take the Next Step? Join countless other practices that have boosted patient satisfaction and expanded their revenue potential through CCM. Contact us today to learn more about how our customized CCM solutions can fit into your practice, enhancing care while optimizing financial performance.

#HCCCODING #HCC #MEDICALCODING #MEDICALBILLING Try to find out what HCC coding is ? As healthcare providers continue to face challenges in medical billing, Hierarchical Condition Category (HCC) coding has emerged as a key tool for right reimbursement. HCC coding is used to determine the expected costs of caring for a patient and is essential in ensuring that healthcare providers are adequately reimbursed for their services. However, HCC coding and documentation can be a complex process that requires attention to detail and a thorough understanding of the coding system. In this article, we will explore some useful HCC coding and documentation tips that can help healthcare providers streamline their billing processes and receive highest reimbursements. Healthcare providers use HCC coding to make sure they get paid the right amount for treating patients. It's like a system that helps them figure out how much they should get paid based on how sick the patient is. Here are some tips to help them do it right: 1. Know the Basics: Before they start coding, healthcare providers need to understand how HCC coding works. It helps them predict how much it will cost to care for a patient based on their health issues. 2. Write Detailed Notes: Good notes are really important for HCC coding. Healthcare providers need to make sure their notes are complete and detailed, showing all the patient's health history, current issues, and treatment plans. 3. Use Specific Codes: When they're coding, healthcare providers should use specific codes that match exactly what's going on with the patient. Using vague codes can cause problems with payments. 4. Keep Notes Updated: HCC coding changes as the patient's health changes. So, healthcare providers need to keep their notes up-to-date with any new information. 5. Use Technology: Technology can make HCC coding easier. Electronic records and special software can help healthcare providers keep accurate records and avoid mistakes. By following these tips, healthcare providers can make sure they get paid properly for the care they provide.