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Welcome to the Fall edition of the Leading Edge.

In our first article, we highlight the work by ACEP and others to push against the trend for lower out of network ER rates.

Next we have documentation reminders for attestation when using scribes, residents and non-physician providers.

Followed by an article on the emerging trend of freestanding emergency departments which are primarily in urban areas and slow to reach rural areas.

Then a reminder about critical care billing guidelines.

Our feature articles begin with a look at telemedicine: is it at a “tipping point?” Many think so despite the barriers that remain.

Next we look at Medicare Advantage. This below-the-radar version of Medicare insures nearly a third of Medicare patients in what otherwise look like commercial plans.

Healthcare exchanges are highlighted in our next feature. Everyone has seen the news about insurers dropping out. But exchanges aren’t going away so expect to see more narrow networks and expanded efforts to attract younger and healthier consumers.

In our final feature, we describe current industry efforts to improve population health.

In the Compliance Corner, you will learn why OIG exclusion checking is so important and about a new AdvantEdge offer that can assist you with exclusion testing.

You can print any article in this newsletter as a PDF and there is a PDF “button” to download the entire newsletter for email or printing.

A last, personal, note. This is my last issue of the LeadingEdge. I am retiring in October. But rest assured that the LeadingEdge and the other AdvantEdge newsletters are in good hands. Hannah Paoletti does most of the heavy lifting and Mike Krivich is on board to take over my end of things. I’m sure the quality of articles will continue to improve, which has always been our objective.

We appreciate your feedback and suggestions. Please call or email Mike with comments and topics: and (630) 874-2545.


Bill Gilbert