ICD-10’s Leadership Crisis: Can CMS Step Up To The Plate?

ICD-10’s Leadership Crisis: Can CMS Step Up to the Plate?

  • August 21, 2014

Medical Practice Insider Associate Editor Madelyn Kearns spoke with Joshua Berman, director of business analytics and ICD-10 for RelayHealth Financial, about how procrastination has hampered readiness efforts; and what CMS, Congress, and physicians can do now to prepare for the fast-approaching go-live date. Read the full interview

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Three Must-Dos For Payers, Providers Seeking Successful Collaboration

Three Must-Dos for Payers, Providers Seeking Successful Collaboration

  • August 14, 2014

“The only way to win is to work together,” advises Holly Toomey, RN, BS, HCA, director, product management at McKesson Health Solutions. Her recent blog post features practical advice for payers and providers navigating the new reality of healthcare: success requires the best possible clinical outcomes at the lowest possible costs. To build a more comprehensive, collaborative relationship between payers and providers, Toomey suggests: An Automated Utilization Management Process – Use electronic tools to streamline requests for treatment, minimizing patient delays and making it easier to exchange clinical and financial information in real time. A Shared Exception-Based Utilization Management System - Set…

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Can Utilization Management Work In A Value-Based World?

Can Utilization Management Work in a Value-Based World?

  • August 5, 2014

Beauty is in the eye of the beholder. And solutions to healthcare’s problems are in the eye of the stakeholder. Payers see the world one way, providers another, and patients still another. Finding solutions that balance stakeholders’ concerns isn’t easy. But it’s not impossible, if you bring the varying points of view together. I've been privileged to work with all stakeholders—payers, providers, and patients—and have heard (and hear) their problems, anxieties, and concerns. It’s from this vantage point that I've been wrestling with the problem of utilization management in a world that’s moving rapidly to value-based models. Today, prior authorization…

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6 Steps To Keep Cash Flowing Post ICD-10

6 Steps to Keep Cash Flowing Post ICD-10

  • March 16, 2014

Hospitals looking to protect their revenue streams need to do more than verify compliance of financial connectivity software. In this issue of Healthcare IT News, Josh Berman, Director of ICD-10 at RelayHealth, provides six steps that payers need to take before the October 2015 deadline. Read the full story

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ICD-10 Testing With Or Without CMS

ICD-10 Testing With or Without CMS

  • March 10, 2014

CMS just concluded a week of limited ICD-10 testing, but only some providers were able to take advantage of it. In an article in Medical Practice Insider, Josh Berman, Director of ICD-10 at RelayHealth, provided advice and some next steps for those organizations not chosen to participate in the CMS testing. Read the full article

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CMS ICD-10 ‘Acknowledgement’ Test Done, Now Comes The Hard Part

CMS ICD-10 ‘Acknowledgement’ Test Done, Now Comes the Hard Part

  • March 7, 2014

In a first step towards the ICD-10 transition, CMS Acknowledgement testing was successful, according to an article in HealthData Management. But Josh Berman, Director of ICD-10 at RelayHealth, said that while the results were reassuring, more needs to be done. The real concern,  said Berman, remains whether insurers will be able to process the claims. Berman urged payers to begin conducting end-to-end testing.  "While most providers were not ready for end-to-end testing three or four months ago, large numbers are quickly getting there and Berman expects end-to-end test requests to ramp up in April and May," the article stated. Read the full article

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ICD-10 And Revenue Cycle Readiness: Six Key Steps

ICD-10 and Revenue Cycle Readiness: Six Key Steps

  • March 3, 2014

The ICD-10 deadline is looming, and payers and providers need to focus on testing, education, and process improvement.  Healthcare Finance News asked Josh Berman, Director of ICD-10 at RelayHealth, what providers can do to weather the transition. Berman shares his advice on the importance of end-to-end testing, training, knowing your KPIs, and being prepared to send both ICD-9 and ICD-10 codes. Read all six readiness steps here

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