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BY SUSAN GATEHOUSE, RHIT, CCS, CPC, AHIMA-APPROVED ICD-10/PCS TRAINER The testing phase for the Appropriate Use Criteria (AUC) Program officially began January 1, 2020. Upon implementation of the program, physicians and other healthcare professionals who order an advanced diagnostic imaging test (MRI, CT, PET, and nuclear medicine; does not include X-rays, ultrasounds, or fluoroscopy services) must consult with AUC using a qualified decision support mechanism (CDSM). Professionals who provide these tests will be required to register the ordering professional’s consultation of AUC to be paid for the service.
Providers will be required to use a qualified CDSM (certified as meeting Centers for Medicare & Medicaid Services/CMS requirements). If a provider does not follow AUC requirements and is discovered to have ordering patterns deemed as outliers, the law mandates that CMS require prior authorization. G-codes are needed for every advanced imaging service, and claims with multiple G-codes “shall be’’ accepted.
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Close the Loopholes on Outpatient Claim Denials: Proactive Measures to Recoup Lost Revenue12/11/2019 BY SUSAN GATEHOUSE, RHIT, CCS, CPC, AHIMA-APPROVED ICD-10/PCS TRAINERUnfortunately, the majority of healthcare organizations encounter claim denials on a reasonably regular basis, often, habitually. Though claim denials may be an unavoidable reality in the world of healthcare, ineffective claim denials management can result in even more lost revenue.
Axea Solutions is honored to be placed on HealthcareTech Outlooks' robust list of the Top 10 Revenue Cycle Management Solution providers of 2019. With decades of expertise developed around coding accuracy and clinical documentation improvement, as well as claims denial management, Axea Solutions is considered to be one of the pioneers in the Revenue Cycle Management arena.
BY SUSAN GATEHOUSE, RHIT, CCS, CPC, AHIMA-APPROVED ICD-10/PCS TRAINER Building Clinical Documentation Improvement (CDI) programs to capture quality data on Severity of Illness, can help to strengthen hospital quality measures by providing granular level reporting of a patient’s encounter – ultimately increasing revenue and mitigating related compliance risk.
The ICD-10 Monitor News, recently featured an article written by Axea’s CEO, Susan Gatehouse on the various distinctions of mortality, morbidity, and the Severity of Illness (SOI). Often, when used in the healthcare environment, these terms are interwoven, however, by definition, they are quite different. Axea’s CEO, Susan Gatehouse -- Featured on Public Television Show hosted by Laurence Fishburne10/8/2019 Axea Solution's CEO, Susan Gatehouse was recently interviewed in a segment for public television on the future of technology and AI in healthcare. Discussing the importance of accurate, actionable data and how it relates to the digital transformation happening in the world of healthcare, Susan shared her insight on the possibilities of the possibilities of these advancements.
BY SUSAN GATEHOUSE, RHIT, CCS, CPC, AHIMA-APPROVED ICD-10/PCS TRAINER Are Social Determinants of Health the Future of Value-Based Care?
In the shift to Value-Based Care Models, Social Determinants of Health (SDoH) are becoming more of a driver. Economic stability, social and community context, neighborhood and environment, and education all play a part in a patient's overall ability to maintain their health. This is precisely why the healthcare industry is seeing an increased focus on SDoH. BY SUSAN GATEHOUSE, RHIT, CCS, CPC, AHIMA-APPROVED ICD-10/PCS TRAINERData for clinical and business intelligence can be the catalyst to uncovering opportunities within clinical documentation improvements, leading to valuable transformational changes in processes. In part II of Susan Gatehouses' article in ICD10Monitor News, Susan expands on how to create a transformational environment, and examines the current state of clinical documentation improvement (CDI), and how implementing feedback and developing connectivity can directly affect operational improvement and quality of care. BY SUSAN GATEHOUSE, RHIT, CCS, CPC, AHIMA-APPROVED ICD-10/PCS TRAINER
Healthcare organizations continue to make significant investments in system overhauls, but has there been real transformation? How can technology translate into economic value, while remaining focused on quality care? In a recently published article in ICD10monitor News, Susan Gatehouse, Axea Solutions' Founder & CEO shared thoughts on how transactional data promotes an informed and proactive environment, which leads to transformed processes. Axea Solutions recognized as one of the 50 Best Work Places of 2019, resulting from survey on innovation and technology organizations by The Silicon Review. Susan Gatehouse, Axea’s Founder and CEO spoke exclusively to The Silicon Review about advanced technologies in healthcare, the power of quality data, and how Axea created a successful, cohesive work environment to perform with integrity, and succeed on merit through the quality of work delivered.
In this month’s issue of Healthcare Technology Outlook CIO Review, the publication announced the “Top 10 Medical Billing and Coding Solution Providers for 2019.” This list includes some of the most prominent organizations in the industry that have excelled with their services portfolio in the enterprise risk management space, and Axea Solutions is honored to be recognized.
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AuthorAxea Solutions bring deep clinical knowledge and revenue cycle reimbursement expertise in clinical documentation, coding, quality and compliance requirements, and health information management. Archives
October 2019
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