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The Medicare Risk Advantage Factor (RAF) And Adjustment Methodology

Centers for Medicare and Medicaid services are changing payments to Medicare Advantage plans to reflect the health status of each beneficiary. CMS uses Medicare advantage risk adjustment methodology to ensure that the Medicare Advantage features work effectively by paying more for registered users, who are expected to cost more to take care and less for …

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Advantages of Electronic Medical Records (EMR) In The Healthcare System

An EMR system is well-defined as an electronic record of health linked information of patients; and the records can be generated, collected, controlled and accessed by authorized clinicians, clinical staff and health care providers. The electronic medical records are in fact digital archive of the patient records that can be organized into digitally accessible archives. …

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Benefits of EHR For Physicians In Improving Quality, Efficiency, And Productivity

An electronic health record (EHR) system is primarily a digital handler of patient health records. The system electronically stores patient health records and is most capable of sharing it with other integrated systems. EHRs are now smart enough to not only handle patient health information rather integrates with a patient portal, record billing information and …

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Pros And Cons Of “Pay For Performance” Policies And Performance Based Compensations

The healthcare law of Patient Protection and Affordable Care, as well as increased transparency and access to patient information on the quality of care providers, has transformed the whole system. Such a shift has paved the path for pay for performance program. What is the incentive of enrolling in the programs, why should there be …

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What Is Vaping? What You Need to Know About Vaping

What is Vaping? It is becoming a popular trend; smokers are stopping out their traditional cigarettes and picking up the Vapes. Vaping is similar to smoking but instead of smoke, it is the inhalation and exhalation of the aerosol. It’s often referred to as vapor manufactured by an e-cigarette or similar device. The terminology is …

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Major Types of Health Insurance Frauds And Their Punishments

What is insurance fraud? Insurance fraud is a willful misrepresentation or falsification that the individual or business makes, knowing that the deception may result in unauthorized use to the person or company or another party. The most common type of fraud is a fabricated statement, misrepresentation or willful mistake that is critical to determining the …

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What Are “Unspecified ICDs” And What Are The Complexities Of Their Use

What is ICD? International; classification of diseases (ICD) is a system used by physicians and health care providers to classify diseases. It is used to classify and code all diagnosis, symptoms, and procedures recorded in conjunction with clinical care, hospitals, and other healthcare facilities. ICD is based on the international classification of diseases. It uses …

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What Are Some of the Major Problems in The U.S Healthcare System?

What determines the best healthcare system is how much the country spends in the quality of the health care provided and what are the outcomes of that spending. Moreover, it depends on the availability of healthcare services and obviously how effective it is at keeping the country’s populous healthy. At what cost, and what consumers …

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Unethical and Fraudulent Medical Billing Practices Are Costing Billions

Last year over 600 individuals were charged for healthcare fraud schemes in the United States involving over $900 million false and unethical medical billing practices. There is no end to it, every year a huge number of medical practitioners are accused of healthcare frauds worth billions. Basically, frauds in the health care industry are no …

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What Are the Benefits Of Electronic Health Records For Patients

Electronic health records are beneficial in numerous ways. Both large and small physician practices are rapidly switching to electronic health records from paper charts. With the implementation of the electronic health record system, it becomes easier for healthcare providers to manage the patient records and optimize their clinical processes. Besides, some simple benefits such as …

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