The Verden Effect

A couple weeks ago, the Verden Alert gave me this little notice about Oxford: Please note that in an effort to become more transparent and communicate more clearly, Oxford has modified its policy change listings. Oxford now posts exactly what revisions have been made to its changed policies. Interesting, because happened shortly after the release …

Ingenix and Open Source in the Same Title?!

It’s Friday, I have a head-cold and sore throat, and all the pressure of farm/T-ball coaching has gotten to me. So, today, I am going to let someone else do all the work. Head over to Crossover Health, where Dr. Shreeve has picked up on an announcement from the Ingenix CEO that they will open-source …

More Practical use of OpenSource In Healthcare

In a way, this reference below could have nothing to do with healthcare. It could be about a bank or software company or real estate agency as much as a hospital, but I think folks need to see their peers in action for it to hit home. Bottom line: every business ought to take its …

Fun with CCHIT (New Child Health Certification Criteria)

CCHIT has announced the new optional Child Health Certification Criteria. Click on the link, read the PDF, get a sense of what hoops the pediatric EHR world is going to have to jump through shortly. I have been critical of the CCHIT certification process before. My position hasn’t changed: CCHIT certification is misused and misunderstood …

More 99050, 99051, 99053, 99058 Madness

As promised, I will show you the money. Click on the picture below (or here) for a better view of the average reimbursement for these scheduling based codes. What we see are fairly consistent reimbursement for the codes with the variation being explained by the additional payers being added on all the time (look at …

Google’s Health Application

After the fall AAP meeting, I wrote about the inherent dangers of Microsoft’s new Health portal. It should be no surprise that Google has gotten into the act – there are hundreds of millions of dollars in ad revenue at stake here, and that’s without selling the amalgamated data. Apparently, Google’s effort might represent a …

After-Hours Codes And Other Scheduling-Based Codes (99050, 99051, 99053, 99058)

In 2008, the CPT definition of the classic “after-hours” codes changed. Gone is all the rigmarole about whether your hours are “posted” or whether your patients know you are open on weekends and all the other commentary that used to convince our clients not to use these important codes. The bottom line: if you see …

Final 96110 and More Personalized Medicine

I have some fascinating data about the after hours, etc., codes (9905x) coming, but I wanted to share these two followup tidbits before I forget: The Developmental Screening Toolkit For Primary Care Providers looks like an excellent site to add to the list I posted the other day. In particular, here’s a great comparison chart …

“We will not sacrifice profitability for membership.”

They usually write themselves. Reason #1156 to pay attention to Susanne Madden and the Verden Group – the AMA itself has turned to her for an analysis of the exodus of patients from many of the large, national plans. Apparently – based on the quote above, from Wellpoint’s CEO – the insurance companies are more …

96110 Reimbursement Followup

As promised, here’s a followup to my 96110 data from the other day. It’s interesting to see how 96110 usage has increased in pediatricians over the years, but what are folks getting paid? Here’s the data: I know it’s hard to read, so click here or on the image to see the entire thing. So, …