Incentives posed by the Institute for Healthcare Improvement's Triple Aim Initiative and value-based purchasing emphasize treating the whole person to include preventive, medical, dental, postacute, community, mental health, and addiction services.
More and more hospitals are choosing to become part of Accountable Care Organizations (ACO) in an effort to streamline patient care and reduce costs. If your organization is considering joining an ACO, you may have questions about how these groups work and how the change might affect your job. CMM asked several experts for the lowdown on what the transition to an ACO might mean for case managers.
Whether it's a precautionary CT scan that may not really be needed or a duplicate laboratory test ordered by separate physicians, many hospitalized patients are getting unnecessary tests, and experts say it's a big problem.
Taxonomy codes play a very important role in medical billing and credentialing for providers or group specialties.HIPAA-standard code sets specify a "standard" for transactions. In many cases, a taxonomy code is required to reimburse a claim; however, the reporting requirements for a taxonomy code may vary between insurance carriers and your third-party payers.
