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healthcare management consulting

Embracing Telehealth Demands as a Small Practice

By | Blog, healthcare management consulting, MIPS consulting

The COVID-19 pandemic resulted in many healthcare providers unexpectedly needing to turn to virtual treatment solutions. The transition may have been relatively smooth for larger healthcare providers with greater resources, but smaller practices had to deal with even more challenges. It wasn’t until the government instituted regulatory changes to broaden reimbursement for virtual visits that the smaller practices began to believe they, too, could move in that direction. As patients began seeing their local practices offer telehealth, their interest also increased.

The very makeup of a smaller practice forces it to think more creatively in planning and adopting emerging telemedicine needs. Some items to keep in mind include patient needs, where they come from, and what technologies they and the medical staff might use to reap the most benefits. Telehealth does not necessarily have to completely replace in-person visits, but practices could offer after-hours consultations to patients or asynchronous services for patients that require ongoing care.

Smaller practices may also wish to seek out telehealth resource centers. In addition to federally funded programs, private companies such as CareOptimize offer comprehensive telehealth services. Providers should also ensure that whatever telehealth solutions they use are compliant with HIPAA regulations, even if those regulations are being temporarily relaxed.

The future of telehealth post-pandemic remains to be seen, but many of the pieces are now in place to give all size practices the ability to institute and maintain successful telehealth programs.

To read more, please visit https://www.healthcareitnews.com/news/heres-how-smaller-practices-can-prepare-continuing-telehealth-demands.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

The Latest Insights Webinar Delves Deep into CPT E/M Changes

By | Blog, healthcare management consulting, Nextgen EHR

This week, we’re back with an all-new CareOptimize Insights Webinar highlighting changes coming with CPT E/M codes.

The code changes will go into effect on January 1, 2021, so it’s time to get your providers and coders ready. This comprehensive webinar explains how to navigate all of the Evaluation and Management changes and what they mean for reimbursement, including which codes to use when, which codes belong in conjunction, and what can be reported. There’s also a 10-step guide from acdis.org on how to successfully transition to the 2021 guidelines.

The Insights2020 CPT EM Code Changes for 2021 is up for viewing on the CareOptimize YouTube channel as well as on our Insights page. Remember you can watch all of our webinars by visiting https://www.youtube.com/careoptimize.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Telehealth Leads to Better Care and Revenue with Chronically Ill Patients

By | Blog, healthcare management consulting, MIPS consulting, Telehealth

Telehealth offers critically ill patients and their healthcare providers opportunities to raise income and improve quality of treatment. Telehealth appointments frequently represent a more convenient approach versus an in-person visit, and the costs are often markedly less than an emergency room visit. Instead of making an unnecessary trip or incurring a hefty emergency room charge, patients using a telehealth platform are able to virtually talk with a physician or a nurse via computer, phone, or tablet.

For healthcare practices, telehealth appointments with chronically ill patients create several revenue opportunities. Regulations have relaxed, and Medicare offers even more leniency when it comes to reimbursing telehealth services. Physicians can now receive the same amount reimbursed for a telehealth appointment as they would for an in-person visit, leading to a more stable revenue stream. Telehealth and remote monitoring for patients with chronic conditions in value-based contracts also enables physicians to reach quality care targets and reduce unneeded readmissions, leading to greater incentive payments.

Regular communication with chronically ill patients solves multiple problems. It’s challenging to keep a consistent chronic care management program going when patients might be afraid to come into the office. Those who need a physical, follow-up visit, or have regularly scheduled appointments, can now keep up with those via virtual visits. As a bonus, providers can also more easily evaluate the home environment with the virtual visit “show and tell” opportunity.

Telehealth has emerged as a good way to provide revenue opportunities, offer more convenience, and avoid interrupting care management programs. Many providers are seeing the benefits.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

How Telehealth Is Changing the Face of Healthcare

By | Blog, healthcare management consulting, Nextgen EHR

Before the COVID-19 pandemic, telehealth was largely used as a secondary tool by clinicians and patients, and mostly for test results delivered via email. Regulatory restrictions helped make for slow adoption. Now that telehealth has been widely implemented, patients and clinicians have quickly discovered its more widespread usefulness. Positive results, especially with virtual doctor visits, ensure telehealth will likely remain a healthcare staple for the foreseeable future.

The rapid implementation of telehealth revealed its many benefits, changing the ways many providers practice. From pediatrics to behavioral health, several common specialties embraced the extensive uses of telehealth. For example, Seattle Children’s hospital was already using it in a limited capacity in the early 2000s but has since seen massive growth. They find it particularly useful when dealing with mental health issues among children and adolescents.

With geriatrics, telehealth creates a considerably greater challenge. Many patients are on numerous medications or suffer from multiple chronic conditions. Others lack even the basic technical abilities. Initiatives to bring this demographic on board are crucial, as these patients are also at significantly higher risk of becoming infected with the coronavirus. Practitioners have doubled down on ways to reach out to these patients not only to help facilitate virtual visits, but also to ensure they have sufficient food, a means of transport, and even housing.

While primary care may be the most obvious fit for telehealth, specialties such as obstetrics, orthopaedics, and even physical therapy have altered their practices dramatically to incorporate telehealth components. To read more, please visit https://medicalxpress.com/news/2020-06-telemedicine-post-coronavirus-world-common-specialties.html.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

EHR-Embedded Telehealth Saves the Day

By | Blog, healthcare management consulting, Nextgen EHR

COVID-19 has forced healthcare practices to find ways to keep their doors open and their patients served. Telehealth has been one of the most successful. A practice based in Blue Ridge, Georgia quickly adapted to the changes by instituting a telehealth system and achieving success.

Blue Ridge Medical Group initially found itself facing difficulty with ongoing patient care as businesses were forced to close. The practice was in dire need of a solution that adhered to HIPAA laws and allowed patient scheduling as well as video conferencing and billing.

After researching telemedicine technology and exploring service vendors, Blue Ridge Medical Group found an EHR-embedded platform that addressed many of its challenges, including initiating video calls with patients to provide ongoing care. Furthermore, patients were also able to use the system with minimal hassle despite many having limited tech skills.

Blue Ridge Medical Group has seen additional perks with their new telehealth program, including being able to document EHR data during a virtual visit by communicating with the patient, ensuring they don’t feel as if they are being ignored.

Telehealth has also proven to be a major plus for older patients that may not be able to physically visit the office due to certain health conditions or being too sick to leave home. These solutions allow patients to attend the all-important visits, allowing continued management of chronic health conditions and/or potential faster recuperation.

CareOptimize provides its own telehealth solutions designed to keep your practice running smoothly. Please visit our website www.careoptimize.com for more information.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, NextGen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

Things to Consider as Healthcare Facilities Move to Reopen

By | Blog, healthcare management consulting, MIPS consulting

Healthcare providers, using the directions mandated by federal and local governments, locked down their facilities to avoid the spread of COVID-19. This also meant shutting down main clinical service lines and canceling in-person appointments for patients. However, vendors are beginning to open their doors once again with the pandemic subsidizing in some regions.

According to recent data collected by The New York Times, the number of reported COVID-19 cases is dropping in close to half of states around the country, with several other states showing no statistically important change.

Just as healthcare facilities have decided to refrain from in-person appointments to minimize exposure, providers will also need to evaluate safety measures to reduce patient and provider contact with the coronavirus.

According to CMS guidelines, the optimization of telehealth services should be a major priority for healthcare facilities. Providers should remain focused on providing virtual care where appropriate to reduce the risk of spread of the virus, especially if they are dealing with patients that have severe or chronic conditions.

Should a scenario arise where in-person care is required, healthcare facilities should seek tele-triage services prior to resuming in-person care. Boosting remote patient monitoring and other telehealth capabilities may also assist providers with ensuring care access for patients who need medical care but are staying away from healthcare facilities due to understandable concerns.

To read more, please visit https://revcycleintelligence.com/news/key-considerations-for-reopening-healthcare-facilities-amid-covid-19.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, next-generation EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

The Push for Extended CMS Telehealth Waivers

By | Blog, healthcare management consulting, MIPS consulting

Many providers and patients have not only become accustomed to the rapidly devised telehealth exemptions, but they also believe it’s an optimum approach to delivering basic healthcare services until the coronavirus is no longer a major threat. This positive attitude about telehealth may also serve as a way to ensure those changes, which some advocates of telehealth were big fans of long before COVID-19 surfaced, become the norm.

Earlier in 2020, CMS took considerable steps to relax regulations relating to the use of telehealth services, stating it was the proper response to make sure patients would still receive services while cities across the country were on lockdown to reduce the spread of COVID-19.

Just over two months later, access to remote care providers has exploded. The powerful American College of Physicists (ACP) lobbying group is one of the groups requesting the changes to remain in place on a long term basis.

In addition to easing regulations and compensation for telehealth services, ACP also wants the newly-granted autonomy to remain in effect in the direct supervision of doctors working at teaching hospitals, along with continuing fee increases for hospital divisions offering these services.

To read more, visit https://www.healthcaredive.com/news/calls-mount-for-cms-to-extend-telehealth-waivers/579264/.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, next-generation EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

The Latest CMS COVID-19 Billing Updates for Hospitals

By | Blog, healthcare management consulting, MIPS consulting

CMS’ latest and revised COVID-19 billing policy seeks to help hospitals and alternative care sites get paid for treatment given during the emergency. Late last month, CMS revised FAQs regarding Medicare fee-for-service billing. The revised FAQs provided more clarity on how CMS enforced an increase in hospital IPPS reimbursement, including the process involved in identifying COVID-19 discharges.

Most of the new questions focused on payments based on the Coronavirus Help, Relief and Economic Protection Act (CARES) for the Hospital Inpatient Prospective Payment Program (IPPS). The CARES Act, passed at the end of March, provides billions of dollars in funding to hospitals and other healthcare facilities, including a provisional 20% rise in IPPS patient reimbursements for hospitalizations related to the pandemic.

According to the FAQs, the amounts hospitals will receive for COVID-19 hospitalizations will vary based on the date of discharge. CMS issued the new payment rates for COVID-19 discharges on and after the 27th of January and on or before the 31st of March, as well as on or after the first of April, over the length of the emergency period.

Along with COVID-19 billing updates for the IPPS, CMS also provided guidelines on how hospitals should bill for services provided at alternative care sites developed to expand capacity during the emergency.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, next-generation EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.

CareOptimize Insights Webinar Is All Telemedicine

By | Blog, healthcare management consulting, Nextgen EHR

Telemedicine has been experiencing immense growth as a result of the COVID-19 pandemic. Practices as well as patients have more information available to them than ever as telemedicine moves to the forefront of healthcare. The next CareOptimize Insights webinar is all about helping you making sense of this new frontier.

This upcoming webinar exclusively discusses telemedicine, including relevant topics such as how it can assist your practice, the challenges it presents, the relaxation of regulatory matters, and where it is headed.

In regard to COVID-19, remember CareOptimize currently provides a pair of free tools to assist with simplifying the monitoring and reporting of coronavirus cases. The template allows you to log in data on patients who test positive or are exhibiting symptoms, then streamline notifications on those patients to the CDC, state health agency, and/or local health department. The report shows all high-risk patients in your organization who should be considered for additional screening or other preventative measures. Bookmark our Insights page or our YouTube channel to view all of our webinars.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, Nextgen EHR utilities, and more. For more information, please call 855.937.8475.

Coronavirus Relief Bill Sets Aside $100B for Providers

By | Blog, healthcare management consulting, MIPS consulting

A relief bill aimed at COVID-19 relief would grant providers an additional $100 billion in aid for expenses related to healthcare and lost revenue caused by the coronavirus pandemic.

The Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, passed by the House on the 15th, is a $3 trillion coronavirus relief bill that seeks to supply further direct payments to an extensive array of coronavirus-affected agencies, businesses and even people. Healthcare organizations and agencies would receive a substantial part of the funding. The legislation also makes improvements to accelerated and variable payment plans under the Medicare terms and an improvement in prospective inpatient prospective payment system outlier compensation under patients that have received a COVID-19 diagnosis. The federal matching rate for Medicaid states is now rising by 14 percent and $75 billion has been set aside to support coronavirus testing and contact tracing.

Ever since the execution of a pair of coronavirus relief packages, the Coronavirus Aid, Relief and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act, hospitals have been petitioning for more federal government funding. Collectively, the packages provided a Provider Relief Fund of $175 billion.

To read more about the HEROES Act, visit https://revcycleintelligence.com/news/latest-coronavirus-relief-bill-seeks-another-100b-for-providers.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, Nextgen EHR utilities, and more. For more information, please call 855.937.8475.