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Why You Need A Quality Improvement Program

WEBThe Health Resources and Services Administration (HRSA) offers the following explanation of QI: A QI program involves systematic activities that are …

Actived: 9 days ago

URL: https://bhmpc.com/2014/02/need-quality-improvement-program/

5 Healthcare Payer Pain Points What Are Your Pain Points

WEBIn addition to this BHM offers a wide breadth of services including healthcare transformation assistance, strategic planning and organizational analysis, accreditation …

Category: Health Go Health

Understanding RVUs Medicare Reimbursement

WEBRVU stands for Relative Value Unit and is currently used by Medicare to determine the amount of reimbursement to providers. RVUs are basically a way of standardizing and …

Category: Health Go Health

The Triple Aim of Healthcare: Healthcare Creative Disruption

WEBImproving the health of populations; and. Reducing the per capita cost of healthcare. While the goal of the triple aim of healthcare is a lofty one, it is certainly achievable. Efforts to …

Category: Health Go Health

The Drive for Healthcare Quality and Pay for Performance

WEBThe Health Resources and Services Administration (HRSA), describes pay-for-performance as a system in which “providers are compensated by payers for meeting certain pre …

Category: Health Go Health

Level of Care Tools Comparing Level of Care Assessment

WEBChild and Adolescent Level of Care Utilization System (CALOCUS ®) uses 7 levels of care to categorize the intensity of patients, interestingly enough starting at level 0: Level 0: …

Category: Health Go Health

5 Trends in Healthcare Reimbursement

WEB5 Trends in Healthcare Reimbursement. The subject of physician compensation is a hot one as of late. With all the changes in the financial sector of …

Category: Health Go Health

3 Trends to Watch in Healthcare Information Management

WEBHere are three trends that are being implemented. 1. Electronic Health Records. In an effort to better facilitate communication among medical professionals and allow access to the …

Category: Medical Go Health

Elevating Care: The Role of Clinical Documentation Improvement

WEBClinical documentation improvement is a vital process that elevates patient care, ensures compliance, optimizes reimbursement and contributes to the overall efficiency and …

Category: Health Go Health

Health Plan Strategies For Member Retention

WEBHealth Plan Strategies For Member Retention. Editor’s Note: Health plans understand that their world is changing. They can no longer function solely as financial entities; they …

Category: Health Go Health

A Payer’s Guide to Case Management Utilization Review

WEBCase Management Utilization Review is a pivotal process in the healthcare sector, aimed at evaluating and ensuring the necessity, appropriateness, and efficiency …

Category: Health Go Health

NCQA Health Plan Accreditation Updates for 2023

WEBThe NCQA Health Plan Accreditation program provides a framework for assessing the quality of health plans and ensuring that they meet certain standards. For …

Category: Health Go Health

What Is Medical Review: Why Is Vital For Payers And Providers

WEBMedical review allows for more efficient patient outcomes and revenue cycles and let healthcare professionals focus on care for individual patients improving everyone’s …

Category: Medical Go Health

Revolutionizing Healthcare: The Role of Informatics

WEBHealthcare informatics, also known as health informatics or medical informatics, is the intersection of healthcare, computer science, and information …

Category: Medical Go Health

Ensuring Healthcare Compliance: Navigating the Complexities

WEBThe Health Insurance Portability and Accountability Act (HIPAA) sets standards for protecting sensitive patient information and ensuring the privacy and security of …

Category: Health Go Health

5 Types of Accountable Care Organizations (ACOs)

WEBNCQA offers 3 levels of accreditation: Level 1: Organizations beginning the transformation and providing the basic infrastructure and some of the capabilities to …

Category: Health Go Health

Managed Care Organizations Sweeping the Nation: Top 10 MCOs

WEBCurrently states are making the transition to Managed Care, or allowing Managed Care Organizations to take the lead in providing healthcare to Medicaid

Category: Health Go Health

5 Critical Insights from Healthcare Chart Audits

WEBHealthcare providers can use audit findings to refine their practices, enhance care protocols, and implement corrective actions to prevent recurring issues. Billing Accuracy: …

Category: Health Go Health

A Humorous Look at Healthcare Reform Through Cartoons

WEBIn addition to this BHM offers a wide breadth of services ranging including managed care consulting, strategic planning and organizational analysis, accreditation consulting, …

Category: Health Go Health

Understanding Medical Necessity: Key Factors and Guidelines

WEBBenefit Design: Health insurance plans often have different levels of coverage for various medical services. Some services may require prior authorization to establish MN, while …

Category: Medical Go Health

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