BHM Wishes You a Safe & Happy Halloween!
October 31, 2015
Happy Halloween from all of us here at BHM Healthcare Solutions!
Category: Uncategorized
The Road To NCQA Health Plan Accreditation
October 27, 2015
Are you a health plan looking into NCQA accreditation? We know that the process can be daunting and often stressful, so we’ve compiled a list of NCQA basics to help those who are pondering an NCQA accreditation. If you are a health plan who has already chosen to pursue NCQA accreditation, take a look at our blog post “NCQA Health Plan Accreditation : The Difference Between Failure and Success.” For those of you just getting started let’s dive into the NCQA basics, from who the NCQA is to an overview of their Health Plan accreditation levels. Hopefully this list helps jump-start your journey towards successful healthcare accreditation.
CMS Announces Meaningful Use Final Rules & Stage 3 Implementation
October 22, 2015
Now that the ICD-10 panic has subsided the healthcare world is focusing on something new: Meaningful Use. Despite mixed reactions from the public and congress, many of whom expressed concern about the proposed changes and rules, The Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) released the final rules for the changes to Meaningful Use Stage 1 and 2, the Stage 3 requirements and the 2015 Edition Health IT Certification Criteria. The mixed reactions are born out of the reports that many healthcare providers that have yet to successfully achieve Stage 2, with “35 percent of hospitals and a small fraction of physicians” meeting the Stage 2 requirements.” If you haven’t been keeping up with the Meaningful Use news you can read some of our blog explaining meaningful use Stage 2 here. The statement from the Department of Health and Human Services (HHS) stated that the final rules and changes would hopefully “add new flexibilities for providers to make electronic health information available when and where it matters most and for health care providers and consumers to be able to readily, safely, and securely exchange that information.”
Eliminating Risk with Independent Review Organizations
October 9, 2015
We’ve been talking a lot lately about how and where Independent Review Organizations, or IROs, fit into denial management. The Peer Review process, which brings in an unbiased third party to help alleviate the pressure of reviewing claims, is an essential part of denial management. We’ve touched on many of the different benefits of IROs in previous blog posts, from how they affect your ROI to how they bring specialized expertise to reviews. This blog post focuses on the four main ways IROs and external reviews can help eliminate risk within your organization.
NCQA Presents HEDIS 2016 Volume 2 with Relevant ICD-10 Codes
October 5, 2015
The NCQA announced on September 29, 2015 that the 2nd volume of HEDIS 2016 (The Healthcare Effectiveness Data and Information Set) would be completely ICD-10 compliant and ready for the implementation day of OCT 1. The NCQA has phased out the ICD-9 codes as per NCQA regulations and added over 73,000 ICD-10 codes, across 56 HEDIS measures. “Health plans, health data clearinghouses and health care providers will now be able to code records to comply with CMS requirements for HEDIS reporting.”
ICD-10: The Countdown is Over – BHM’s Last Minute Tips
October 1, 2015
October 1st is here and with it arrives ICD-10. Whether the looming implementation date of the new codes sent your organization into a state of urgency or the date felt like a non-event, ICD-10 is here. There will be a strong focus on the transition to ICD-10 in the coming months and we know it isn’t going to be easy, as resources and employees get allocated to fix errors and educate staff. It’s important to remember that focus and communication will be key to get through the ICD-10 era. To help make this transition less overwhelming we have complied a list of seven last minute tips to help you successfully transition to ICD-10.
Guest Editorial: Innovation in Healthcare is Not a Technology
September 29, 2015
This week’s Guest Opinion/Editorial comes Christopher Wynder is the Director of Client Services for ThinkDox.
Depending on the blog, survey, or new product review that you read “healthcare” is either: in a crisis caused by technology or is about to be saved by technology.
The Status On ICD-10 Implementation [Infographic]
September 25, 2015
Our guest post this week is from Practice Bridge and covers the very near implementation date of ICD-10. “We will be using ICD-10 in a just over a week. But before that do you know the status on ICD-10 implementation? With the help of coding veterans and influencers, I have come up with few facts most healthcare professionals miss out. In this infographics our experts have shared 6 foundation blocks for successful ICD-10 implementation. Let me break down the facts and foundations for you.”
NCQA Releases Health Insurance Plan Ratings For 2015-16 & Debuts New Rating System
September 23, 2015
On September 17, 2015 the NCQA announced the release of the 2015-16 Health Insurance Plan Ratings, debuting the new ratings methodology as well. These ratings, which are shift from the “ranking” system previously used by the accrediting body, compare the services and quality of over 1,000 health plans. These ratings “provide consumers with a more accurate picture of how health insurance plans perform in key quality areas.” The easy to use system lets consumers search for health plans by state, and plan name or plan type (Private, Medicaid, Medicare). Consumers can also sort the listings by Accredited Status, Consumer Satisfaction, Prevention, and Treatment (in addition to rating). Top performers nationwide, with an overall 5.0 rating and 4.5 Consumer Satisfaction include: Capital District Physicians’ Health Plan, Harvard Pilgrim Health Care, Kaiser Foundation Health Plan of Northern California.
5 Ways IROs Can Increase Your ROI
September 21, 2015
IROs can help control costs and save you money (and resources) when it comes to all sorts of claims, not just medical necessity; and if you’re stuck trying to choose one, we have plenty of online resources to help you out! From the evidence based approach to hyper-specialization, here are five ways that Independent Review Organizations (IROs) can help boost your return on investment.
