Why Plans Should Focus on Accurate Documentation Capture for Health Risk Assessments (HRA’s), for 2014

The HAUTE HCC Blog with TMI:  Free HCC Resources and TIPS For 2014 – dedicated to HCC Coding and Risk Adjustment for Medicare Advantage Plans By Holly Cassano, CPC, AAPC ICD 10CM Certified, Director of Coding Education and Compliance for Tactical Management Inc., (TMI) Part 1 In November 2013 The Centers for Medicare and Medicaid […]

Navigating Medicare Policy on Physical Therapy and Other Services

For years, some people on Medicare had difficulty getting insurance coverage approved for physical therapy, occupational therapy and other treatments. The prevailing approach was that if the therapy was not helping to improve a patient’s condition, then it was not eligible for coverage. “They’d get denied because they weren’t improving, or because they had plateaued,” […]

Report shows $6.7 billion in improper Medicare payments

WASHINGTON — Medicare paid out $6.7 billion in 2010 for health care visits that were improperly coded or lacked documentation, a report released Thursday found. That’s 21% of Medicare’s total budget for diagnostic and assessment visits, according to the Department of Health and Human Services inspector general. They found that 42% of diagnostic and assessment […]

The Winter of Discontent and How About That April Fools? May 27, 2014

TMI’s ITen Tuesdays – Keep Calm and Code On! By Holly Cassano, CPC, AAPC ICD 10CM Certified, Director of Coding Education and Compliance for Tactical Management Inc., (TMI) The Winter of Discontent and How About That April Fools? May 27, 2014 Well, if you don’t know by now or have been living under a rock […]

So CMS Thinks Mr. Jones’ Leg Grew Back, How Do I Tell CMS, it’s Still MIA?

The HAUTE HCC Blog with TMI:  Free HCC Resources and TIPS For 2014 – dedicated to HCC Coding and Risk Adjustment for Medicare Advantage Plans By Holly Cassano, CPC, AAPC ICD 10CM Certified CLIFF Notes for HCC Coding – A Three Part Series on Hierarchical Condition Categories (HCCs) In this installment of “CLIFF Notes for […]

The ACO Hypothesis: What We’re Learning from the Medicare Shared Savings Program

Last month, the Center for Medicare and Medicaid Services (CMS) reported first-year results from the Medicare Shared Saving Accountable Care Organization Program (MSSP). As noted in a previous post, shifting to an accountable care model is a long-term, multi-year transition that requires major overhauls to care delivery processes, technology systems, operations, and governance, as well […]

The Changing Landscape of Medicare Advantage Plans in 2014

By Holly Cassano, CPC, CEO ACCUCODE Consulting LLC, in partners with Tactical Management Inc., (TMI) Medicare Advantage Plans have existed now for nearly a decade and since their inception in 2006, when they covered approximately 8 Million lives, they have grown to about eight times that size, as of 2013, to approximately 46 Million lives. […]

The Haute HCC Blog: The 2014 Provider’s Guide To Winning With Medicare Advantage

The Haute HCC Blog: The 2014 Provider’s Guide To Winning With Medicare Advantage   By Holly J. Cassano, CPC, CEO                                  October 10, 2013  Well October 1st, 2013 marked the one year date for ICD 10 implementation and with that brings the subject of HCC coding for Medicare Advantage Plans in 2014.   What is at the […]

Medicare Advantage Plans Can Cut Costs and Hassle

Here’s something to consider when Medicare’s open enrollment period starts October 15: a private Medicare Advantage plan. Enrollment hit a record high this year, with 14.4 million individuals, or about 28% of all Medicare beneficiaries, in these private insurance plans—a 30% jump in the past three years, according to the Kaiser Family Foundation. Advantage plans […]

Guidance and “Free-Sources” – Don’t Be In Denial Over Denials

Trending with TMI – Weekly Hot Topics in Healthcare:  Guidance and “Free-Sources”   Don’t Be In Denial Over Denials – The Top Challenges For Providers, August 9, 2013  By Holly Cassano, CPC, CEO – ACCUCODE Consulting LLC, in partners with Tactical Management Inc., (TMI)  Practice Managers, Coders, Billers and Providers, can all relate to this often […]