Harmony Healthcare

Harmony Healthcare provides healthcare organizations with the talent and resources needed to succeed today as well as the foresight to prepare for tomorrow’s challenges. In this employee spotlight, we’re excited to highlight Kathy Pride, Director, Coding Solutions. We spoke with Kathy to share her advice for clients and coding professionals as well as insights from her career journey. 1. Tell us about your journey in healthcare? My introduction to healthcare began when I was a unit secretary in a hospital. Although that role wasn’t the right fit, it led me to return to school, where I discovered the field of…

Centers for Medicare and Medicaid Services (CMS) issued a press release at the end of May stating that they will be ramping up Risk Adjustment Data Validation (RADV) audits. There will be 2000 coders auditing 200 patient charts across 550 Medicare Advantage (MA) plans. The numbers are up from 40 coders auditing 35 patient charts across 30 MA plans prior to these planned audits. These retrospective reviews will occur from 2018-2024 and should be completed by early 2026. Extrapolation will occur following the audit to recoup the estimated $17 billion in overpayment to MA plans. Outpatient Clinical Documentation Integrity (CDI)…

Revenue Cycle Management (RCM) is the backbone of healthcare finance, encompassing every step spanning from patient registration to final payment. However, many organizations face recurring pitfalls that can drain revenue, frustrate staff, and diminish patient satisfaction.   Here’s a look at the most common RCM pitfalls and actionable strategies to avoid them.  Incomplete or Inaccurate Patient Information  One of the most frequent RCM errors is collecting incomplete or incorrect patient data during registration. Even minor mistakes like a misspelled name or wrong insurance ID can lead to claim denials and payment delays. How to Avoid:  Train front-desk staff to verify all…