Category: Blog

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Unprocessed CMS-1500 Claims? Check the Date

Medicare claims that do not meet date format requirements will be rejected. The Centers for Medicare & Medicaid Services (CMS) has released date formatting guidelines for the CMS-1500 claim form, which are effective for claims received on or after July 30. When date formatting requirements are not met, Medicare Administrative Contractors will return claims as […]
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CMS Finalizes 2018 MPFS Payment and Policy Changes - Allzone

Anesthesia & pain management – CMS’s 2019 proposed payment rule: 6 key points

The CMS’ proposed Medicare Physician Fee Schedule for 2019 includes changes to the quality payment program and a slight increase in the anesthesia conversion factor. Here’s what you need to know: The national conversion factor for anesthesia services will see an increase from $22.1887 to $22.2986. The increase includes the 0.25 percent positive and budget […]
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HIPAA Compliance Tips For Small Medical Practices

You’ve seen the headlines splashed on TV and across the internet: data breaches hit national businesses such as Target, Chipotle, and many large healthcare systems. But data breaches don’t just affect large corporate entities, they affect small healthcare organizations as well. Take the case of Holland Eye Laser Surgery in March 2018. Their five-provider group […]
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Artificial Intelligence Can Alleviate Revenue Cycle Management Challenges

Artificial intelligence can alleviate revenue cycle management challenges About 64 million adults in America struggle to pay their medical bills. In fact, one in five Americans is considered to have delinquent medical debt. As high-deductible health plans (HDHPs) have grown in popularity over the past couple of years, patient financial responsibility continues to increase, making […]
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Transitional Health Insurance Plays Key Role in Coverage

Transitional health insurance can be a critical benefit for individuals in the midst of financial uncertainty or major life changes. Transitional health insurance, otherwise known as a short-term health plan, is a temporary insurance policy intended to provide stop-gap coverage when an individual is in between ACA compliant policies. The National Association of Insurance Commissioners […]
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Key Terms, Components of Payer Contracts Providers Should Know

Understanding the terms and provisions in a payer contract is key to maximizing reimbursement, preventing denials, and operating a smooth revenue cycle. Providers are in the business of keeping their patients healthy. But confusing payer contracts riddled with “legalese” and other complicated provisions can get in the way of improving patient outcomes. Payer contracts define […]
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Medicare to Cover Glucose Monitoring on Smartphones

The Centers for Medicare & Medicaid Services (CMS) is modifying its Medicare coverage policy for continuous glucose monitors (CGMs) to support their use in conjunction with smartphones, including the data sharing function CGMs provide. Medicare coverage of therapeutic CGMs began in January 2017, but the policy limited their use in conjunction with smartphones. CMS is […]
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CMS Finalizes 2018 MPFS Payment and Policy Changes - Allzone

CMS Policy To Reduce Hospital-Acquired Infections Has Minimal Impact On Reimbursement

A decade ago, CMS enacted Hospital Inpatient Prospective Payment System (IPPS), a policy that penalizes hospitals for hospital-associated conditions (HAC) not present during admission. Recent research published in Infection Control & Hospital Epidemiology has shown the program has had minimal impact on hospital reimbursement. The researchers also found associated billing codes were “rarely used” by […]
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News Alert: ICD-11 Codes Released by WHO

A major shift in the reporting of transgender issues is at hand. They’re here, but it won’t be until sometime until after 2022 that the United States is expected to adopt the codes of ICD-11 – the new International Classification of Diseases, Version 11 – released by the World Health Organization (WHO) in Geneva. According […]
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