EAPG

Blue Cross Blue Shield Enhanced Ambulatory Patient Grouping (EAPG) methodology for calculating reimbursement for outpatient procedures http://www.okoha.com/OHA/Hotline/2015/April15/Taking_charge_of_the_EAPG__Improve_your_negotiations_with_BCBS.aspx

E/M changes

December 30, 2019 By admin Leave a Comment

Changes coming in 2021 2020 looks to be a transition year on the payment front, as many programs and changes expected to go into effect this year have been delayed until 2021. These include new CMS-created primary care models and a streamlining of evaluation and management level-of-care coding. CMS announced in October its newest alternative […]

National Rural Health Center

September 19, 2018 By admin Leave a Comment

https://www.ruralcenter.org/ Collaborating and innovating to improve the health of rural communities.

Clean Claim Rate (CCR) and First Pass Rate (FPR)

September 4, 2018 By admin Leave a Comment

Two metrics important to the discussion of creating claims most likely to be immediately reimbursable are Clean Claim Rate (CCR) and First Pass Rate (FPR). Though sometimes confused for one another, these are separate statistics, each worthy of optimization. HFMA identifies the value of CCR as an indicator of the quality of data collected and reported. […]

IDN definition

April 23, 2018 By Ed Slingsby Leave a Comment

An Integrated Delivery Network (IDN) is a formal system of providers and sites of care that provides both health care services and a health insurance plan to patients in a defined geographic area. The functionalities included in an IDN vary, but can include acute care, long-term health, specialty clinics, primary care, and home care services—all […]

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EAPG

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