Reimbursement

The specificity of ICD-10-CM codes allows providers to communicate correct clinical information to third-party payers and across the healthcare continuum.

Medicine is an essential service. Yet, healthcare providers still need to make enough profit to cover their overhead costs if they want to keep their doors open. That is why it is essential for your business and community that claims are processed accurately and that you get reimbursed for your services.

Blue Cross Blue Shield (BCBS) is implementing value-based care and payment models across the country to reward quality and improve outcomes, and these are amounting to billions of dollars in cost-savings and reduced hospitalizations.

Economists predict that, in less than 3 years, the average household in the United States will use 50% of its income on health insurance and out-of-pocket medical bills. According to Lee N. Newcomer, MD, MHA, Senior Vice President, Oncology, Genetics and Women’s Health, UnitedHealthcare, Minnetonka, MN, creating payment models that can reimburse physicians for cost-effective care is difficult in itself, but demonstrating that the new models are indeed cost-effective involves another set of hurdles.

An analysis of payer and provider responses to key clinical information presented at the ASCO 2011 annual meeting offers a glimpse of the oncology landscape shared by oncologists and health plans.

An analysis of payer and provider responses to key clinical information presented at the ASCO 2011 annual meeting offers a glimpse of the oncology landscape shared by oncologists and health plans.