HealthcareNOW Radio InterviewsNOW: Current Issues Affecting Payers, Providers & Beneficiaries with Andria Jacobs

Host Shereese Maynard talks to Andria Jacobs, RN, MS, CEN, CPHQ,COO of PCG Software, a provider-payer software solution. The conversation focuses on current issues affecting payers, providers and beneficiaries including claims denials, issues related to Observation Status designation, medical identity theft, and medical billing fraud.

To listen to the full episode, visit HealthcareNOW Radio.

Part B News Work on Your MDM, Seize Time-Based Opportunity Under Planned E/M Rules

With E/M documentation guidelines getting a makeover in 2021, losing history and exam as factors means it will be more important to properly document medical decision-making (MDM) and, if you bill on time, time spent in non-face-to-face services.

“Providers have trouble documenting MDM,” says Andria Jacobs, chief operating officer of PCG Software in Las Vegas. “Doctors are always thinking how to do it, but writing it down becomes a challenge.”

To read the full article, visit Part B News.

HealthDataAnswers PCG Software Launches iVECoder® to Reduce Claims Denials and Resubmissions for Medical Practices

PCG Software (@PCGSoftware), a provider of software solutions designed to slow the escalating costs of healthcare, announced the launch of iVECoder®, a coding and billing intelligence platform for medical practices of all sizes and specialties. Through the cloud-based software subscription, providers can now ensure even the most complex claims are clean and accurate before they are sent to the payor – using the same Virtual Examiner® intelligence claims review engine that healthcare payors worldwide have been using for more than 25 years to determine which provider claims to approve or deny.

To read the full article, visit Health Data Answers.

American Journal of Managed Care Claims Software Can Reduce Denials, Maximize Revenue

A recent MGMA Stat poll showed that two-thirds of medical practices say that Medicare payments for 2019 won’t cover their costs for delivering care. That’s sobering news, not only for physicians, but also for people who are on Medicare and want their doctors to continue to accept the federal insurance.

Alternative payment models in Medicare come with the promise of increased pay, but participation requires that practices spend more up-front with the hope that heightened reimbursement arrives at some future date.

Medical practices are leaving money on the table by not producing clean medical claims. Incremental improvement can improve cash flow and reduce accounts receivable days, important metrics to determine the health of a medical practice.

To read the full article, visit American Journal of Managed Care.

The Doctors Company Electronic Health Records Lead to Medical Malpractice Suits

The following information appeared on

A patient was treated with trigger point injections of opioids for pain management. The physician intended to order morphine sulphate 15 mg to be administered every eight hours. The electronic health record (EHR) drop-down menu offered 15 mg and 200 mg. The physician mistakenly selected 200 mg. The patient filled the prescription and took one dose with Xanax. The patient developed slurred speech and was taken to the emergency department (ED), resulting in overnight hospitalization and a malpractice claim against the physician for emotional trauma and the costs of the ED and hospital stay. This type of EHR-related medical malpractice suit is becoming more common. For eight years, claims in which the use of EHRs contributed to patient injury have been on the rise.

To read the full article, visit

For The Record Know Thy EHR

Hospital staff can often be less than satisfied with their facility’s EHR, leaving organizations with the challenge of how best to optimize their systems while avoiding discontent. The problem is a common one, often caused by an array of issues—poor design, unmet expectations, and shoddy implementation, among others.

By understanding the underlying causes of staff dissatisfaction and addressing those problems, hospitals can better enable a smooth transition to a new EHR system or take better advantage of the current iteration.

To read the full article, visit For The Record

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