ICD-10

Medicaid Analytics Support Social Determinant Incentive Payments

September 14, 2017 - Payers looking for innovative ways to control the costs of care have been turning their attention to the social determinants of health, the non-clinical factors that often lead to issues with care access, non-adherence, and the development of chronic disease. Social determinants contribute to the billions of dollars spent on chronic disease...


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Top 3 Ways Payers and Providers Can Reduce Claim Denials

by Vera Gruessner

When it comes to medical claims management, healthcare payers and providers will need to communicate more effectively so that both parties are on the same page when it comes to claim denials....

4 Elements Necessary for Switching to ICD-10 Diagnosis Coding

by Vera Gruessner

On October 1, 2015, the healthcare industry from payers and federal agencies to hospitals, physicians, and specialists transitioned to ICD-10 diagnosis coding. Many healthcare providers were concerned...

How ICD-10 Diagnosis Coding Impacts HEDIS Quality Reporting

by Vera Gruessner

On October 1, 2015, healthcare providers and payers across the entire nation switched over to ICD-10 diagnosis coding and left the ICD-9 coding behind. Today the ICD-10 diagnosis coding system is being...

Top 4 Policy Changes Affecting the Health Payer Market in 2015

by Vera Gruessner

The last year has had a huge impact on the health payer market as well as the entire healthcare industry from providers and educational institutions to the federal government and the patient community....

Claims Processing Found Successful after ICD-10 Transition

by Vera Gruessner

Now that the ICD-10 transition has taken place across the country over the last month, the number of diagnosis codes has grown tremendously and many are wondering whether healthcare providers and...

CMS Reports Few Claim Rejections with ICD-10 Coding System

by Vera Gruessner

On October 1 of this year, healthcare organizations including payers and providers around the nation switched over from ICD-9 coding to the new ICD-10 version for diagnostic coding. Along with...

How Providers can View Claim Status after ICD-10 Transition

by Vera Gruessner

With hospitals, clinics, and health insurers moving fully into the ICD-10 transition over the last several weeks, it becomes imperative for providers and payers to determine whether their systems are...

3 ICD-10 Implementation Concentrations for Healthcare Payers

by Jacqueline DiChiara

As healthcare payers adjust their business models to more cleanly align with the continuously evolving ICD-10 landscape, immediate concern is being placed upon where payers should...