Med-Certification

MEDICAL PAPERWORK REDUCTION?
Not so long ago, there was a big push to reduce the amount of paper generated in health care. A major effort was also underway to computerize all medical records to improve access from the many specialists/providers that have become involved in taking care of a patient. Millions were spent but no standards were ever set forth to make sure that the many vendors involved would develop records that could not only communicate with payers but which would be able to interact with other versions. Sadly, that effort ended up creating almost as many problems as it solved. The “computerized” record required fitting information into vendor specific formats and ate much of the time a provider could have used treating a patient.
Meantime, the paperwork actually increased largely because of the HIPAA act which created more documentation designed to “protect” privacy and establish a record that showed that the privacy had been protected complete with a signed copy by the patient or guarantor that they had been advised and received a COPY. Often those entry forms grew from 1 or 2 to 15 or more actual pieces of paper.
Medical billing, always relatively complicated, had lots of new rules related to new codes, proof and documentation for the diagnosis and treatment, and the growing concern about the quality of medical care, its outcome, and how to create the data to track and mine it for various purposes.
On July 12, 2018, the Centers for Medicare & Medicaid Services (CMS) proposed historic changes that would increase the amount of time that doctors and other clinicians can spend with their patients by reducing the burden of paperwork that clinicians face when billing Medicare. They set up listening sessions all over the country and heard from thousands of providers. One thing they consistently brought up was how documentation was needlessly burdensome, wasn’t improving patient care, and was actually having a negative impact on patient care. CMS listened and in response proposed streamlining the documentation requirements for the tricky Evaluation and Management (E&M) codes and descriptors, as well as moving to single payment rates.
CMS Video (((

CMS Patients Over Paperwork E&M Coding Introductory Video CMS heard from doctors and clinicians all over the country that documentation was needlessly burdensome, wasn’t improving patient care, and was actually havi...

Medical Billing, Transcription, Coding Certification & Training Courses Medical coding and billing training and certification. Click now for online medical career training, practice testing and certification.

Medicare Quality Payment Program.
The Quality Payment Program improves Medicare by helping providers focus on care quality and in making patients healthier. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, which threatened clinicians participating in Medicare with potential payment cliffs for 13 years. If a provider participates in Medicare Part B, s/he is part of the team that serves more than 55 million of the country’s most vulnerable Americans, and the Quality Payment Program (QPR) will provide new tools and resources to help patients get the best possible care. Doctors may choose how to participate based on practice size, specialty, location, or patient population.
The Quality Payment Program has two tracks:
• Advanced Alternative Payment Models (APMs) or
• The Merit-based Incentive Payment System (MIPS)
Participating in an Advanced APM, through Medicare Part B incentive payments are earned with an innovative payment model.
Participating in MIPS, a performance-based payment adjustment is earned.
Who's included?
Providers in an Advanced APM or if Medicare is billed more than $30,000 a year and care is provided for more than 100 Medicare patients a year. If fewer patients or lower billing amounts, providers are not included in the program.
All physicians are required to comply with MACRA rules in 2017 to stop Medicare payment reductions.
Based on the data submitted, future reimbursement will be increased or decreased depending on performance using the quality and cost metrics.
The new guidelines are based on a complicated scoring system that requires just about every single practice to modify what and how they record their patient encounters. Basically, the metrics reported in 2017 will make a significant difference in future revenue.
Deadline: January 1st, 2017 the reporting rules must be used correctly, or your future Medicare payments will suffer.

LEARNING AND CERTIFICATION
With the proliferation of educational opportunities in school or on-line, it is important to have the tools to evaluate the effectiveness of the programs offered. Learning outcomes describe what is expected if a training program is selected, including anticipated understanding, knowledge, skill, and competency.
Medical careers increasingly require certification to help assure compliance with the regulatory and privacy acts to protect private information as well as show competency with skills required in a given employment situation.
For both career certification and for educational training, the knowledge-based outcome should prove and be able to show evidence of what was learned, or if on the job experience, the level of competency may be.
The outcome and certification tests devised by Med-Certification.Com are designed to test and report the competencies achieved in a given career whether the knowledge and skill are a result of on the job training or more formal training programs. The tests require the ability to clearly understand a question, then analyze and solve the problem posed whether it is based on the language of medicine, medical protocols, billing or coding questions, or privacy laws.

We understand that certification is important for certain jobs but maybe we are getting a little carried away? Here's one we actually received from a coder:
Sharon D...., CPC, CPC-H, CPC-I, CMSCS, CHCI, CPPM...just sayin'

ICD-10 = More Information
OK, so we have lots of new codes designed to capture lots more information and hopefully lead to better and more comprehensive medical care. It’s true it will create a lot more effort, but here are some examples of why it will increase the data side of things and address improved care issues.
A broken toe was pretty simple to ICD-9 code - decide from the record what kind of a fracture it was and that was that. With the ICD-10 codes,add what toe it was, which part of the toe was involved, and whether it was on the left or the right foot. Orthopedic codes are particularly complex defining whether the bone broke through the skin, how the healing is progressing, if the bone fragments aligned correctly after treatment, etc.
With accidents, an animal bite (pretty generic) may be refined to what animal it was, horse, cow, dog, snake? Or....a chicken?