Amanda Wetzel

ON-DEMAND WEBINAR: Is your RCM partner up to today’s security challenges? If you’re unsure, it’s time to find out. Watch to uncover how recent cybersecurity events have refocused vendor-selection requirements and what to evaluate during review.  #Cybersecurity #RevenueCycleSecurity #RCMSecurity

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Adjusting to risk: Seizing opportunities in risk adjustment coding Wednesday, May 1, 1-2 p.m. EST Speakers: Crystal May, Risk Adjustment Consultant, Norwood; Brian Murphy, Branding Director, Norwood and host of Off the Record; Register here: https://lnkd.in/gPDewtDY It’s often been said that the only constant in life is change. And the mid-revenue cycle is no exception. As new regulations emerge and new technologies develop, professions get radically transformed—or even erased altogether. The antidote is a commitment to lifelong learning, and embracing the discomfort that accompanies growth. Join Crystal May, CCS, CPC, CDEO, CPMA, CRC, Approved Instructor, Risk Adjustment Consultant for Norwood, and Brian Murphy, host of the Off the Record podcast, for this free one-hour live webinar. Crystal and Brian will discuss Crystal’s healthcare journey that eventually led to risk adjustment. They’ll also review some of the common findings and coding errors she’s seeing while conducting in chart reviews. This is not a technical .ppt-driven presentation, but a conversation about Crystal’s journey that may provide fuel for your own career in risk adjustment. Note: No CEUs will be provided for this program. Register here: https://lnkd.in/gPDewtDY

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Adjusting to risk: Seizing opportunities in risk adjustment coding Wednesday, May 1, 1-2 p.m. EST Speakers: Crystal May, Risk Adjustment Consultant, Norwood; Brian Murphy, Branding Director, Norwood and host of Off the Record; Register here: https://lnkd.in/gPDewtDY It’s often been said that the only constant in life is change. And the mid-revenue cycle is no exception. As new regulations emerge and new technologies develop, professions get radically transformed—or even erased altogether. The antidote is a commitment to lifelong learning, and embracing the discomfort that accompanies growth. Join Crystal May, CCS, CPC, CDEO, CPMA, CRC, Approved Instructor, Risk Adjustment Consultant for Norwood, and Brian Murphy, host of the Off the Record podcast, for this free one-hour live webinar. Crystal and Brian will discuss Crystal’s healthcare journey that eventually led to risk adjustment. They’ll also review some of the common findings and coding errors she’s seeing while conducting in chart reviews. This is not a technical .ppt-driven presentation, but a conversation about Crystal’s journey that may provide fuel for your own career in risk adjustment. Note: No CEUs will be provided for this program. Register here: https://lnkd.in/gPDewtDY

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Are you tired of lost revenue due to denied claims? NEMT providers need a proactive and effective denial management strategy. We've got you covered. Discover the ultimate guide to conquering medical billing denials in NEMT. These strategies help ensure you recover lost revenue and elevate patient care. ✅Review All Claim Details ✅Be Persistent ✅Address Problems As Soon As Possible ✅Understand the Appeals Process ✅Keep Records Throughout the Dispute Process Read a complete guide: https://lnkd.in/gJDnsHwr #NEMT #MedicalBilling #NEMTBusiness #NEMTIndustry #TobiNEMTSoftware #Tobi

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Florida has made a significant adjustment to the Personal Needs Allowance (PNA) for Assisted Living Facility (ALF) residents on the Medicaid LTC program. Effective July 1st, the PNA will increase from $54 to $160 per month. The PNA rate of $54 had been stagnant since 2001 and had not seen any increases even though Nursing Home LTC recipients had increases in previous years.  This increase will make a significant difference in the lives of these residents allowing them more freedom and flexibility to purchase needed items and the occasional splurges.  The bill responsible for this change is House Bill 5001 (2024) - The Florida Senate (flsenate.gov). How do you see this impacting your ALF rates daily lives? Do you think this is enough of an allowance for the beneficiary? Start the conversation below. #Florida #postacutecare #ALF #Medicaid #Consultants

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New year, new model! CMS has announced updates to the 2024 Medicare Advantage risk adjustment model, including more Hierarchical Condition Categories (HCCs) than the previous system. Read our latest blog to learn more about the new updates: https://hubs.li/Q02wgNS10 #riskadjustment #medicareadvantage #medicare #hcc #cms

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Credentialing Tips for the Solo Clinician or Group Practice Keeping track of the expiration dates on all insurance contracts is critical to maintaining your revenue flow. If your contract expires, or if you don't have your information updated, payers can shift your status from in network to out of network overnight. We encourage, whether it’s been 6 months or 6 weeks, to ensure that you are still credentialed on the insurance. One easy way to keep track is to maintain a spreadsheet with all of your credentialed insurances and corresponding expiration dates and check it monthly.

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Medical billing software plays a crucial role in the efficient operation of small medical practices by offering several key benefits. Lets unpack the importance of medical billing software for small practices: https://ow.ly/sk3z50Rexti

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The updated federal policy, confirming that Medicare Advantage plans must pay for hospital stays in accordance to the Two-Midnight Rule, is sparking much debate within the healthcare industry. In this Modern Healthcare article, insurers like Humana and Aetna are reporting higher utilization costs due to more inpatient stays, while others like UnitedHealthcare haven't seen a significant financial hit. Hospitals may see a revenue boost, but some report no change. Unresolved issues remain, including the debate over insurer use of artificial intelligence to review claims and hospitals' concerns about potential delays or denials of coverage for Medicare Advantage patients. Overall, we expect hospitals to see an increase in reimbursements as insurers who have not been complying with the Two-Midnight Rule will hopefully now comply. Stay tuned as we continue to monitor developments!

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FRAUD. Every health plan, TPA, and state Medicaid Director knows there is actual fraud happening in their system. The problem is that they can't see it or can't see it fast enough to prevent payment to stop bad actors before damage is done. The primary reason is that every legacy healthcare claims editing system is claims data-centric. To see dynamic fraud and collusion schemes, and to see them fast enough, claims editing and claims analytics must be provider-centric NOT claims data-centric. Learn how to Find, Fight, and Prevent Fraud Fast™ with the patented power of Integr8 AI Risk Detection technology™ at HPRI East, May 22-23 in Boston. Healthcare Payment & Revenue Integrity Series (HPRI) #HPRIEast #Paymentintegrity #paymentintegrityvendors #fraud #healthcarefraud #healthcare #AI

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