Value-based care in 2024: As 2024 approaches, healthcare is undergoing unprecedented innovation and digital transformation. Emerging technologies and capabilities are empowering organizations, including payers, providers, and self-funded employers, to confidently embrace risk within value-based care programs. The American Academy of Family Physicians reports that 49% of practices participate in some form of value-based payment, and […]
Low-dollar accounts receivable for 3 Tips: This can be done effectively, efficiently, and profitably by following the three pillars of low- dollar AR below. Leveraging Offshore Resources for Enhanced Revenue Cycle Management Data doesn’t just tell a story, it can also provide a roadmap for managing low-dollar balances. Use data to identify accounts with the […]
Preventive Services Vs Office Visits: It is important to note that Medicare does not cover preventive services in the same manner as commercial payers. Therefore, it is important to know the patient’s policy and insurance coverage. Table A shows a breakdown of the coverage parameters. Understanding the distinction between Preventive Services Vs Office Visits is […]
MA rates face a potential 0.2% reduction as proposed by CMS. However, analysts said regulators are likely to increase the payout rate in the final announcement. Medicare Advantage health insurers will see a slight decline in their payment MA Rates in 2025 as a new regulatory proposal is finalized. CMS released interim reimbursement rates for […]
2024 MPFS Final Rule: If you don’t have time to read the final medical fee schedule rule, be sure to read this section. Medicare policies may have a significant impact on all payer policies. Therefore, it is important for anyone working with health insurance claims to be aware of policy changes in the New Year. […]
NSA Implementation Shortly before Congress adjourns for 2023; lawmakers sent another in a series of letters to the Centers for Medicare and Medicaid Services (CMS) expressing “serious concerns” about the implementation of the No Surprises Act (NSA). The letter accused CMS of failing to properly implement key portions of the law and suggested that the […]
An improved Prior Authorization Final Rule can result in shorter wait times, fewer delays in the delivery of patient care, and a reduction in costs. CMS has finalized the Interoperability and Prior Authorization Final Rule (CMS-0057-F), which was published by CMS on January 17, 2024. It will reduce the burden on patients, providers, and payers […]
Medical coding challenges: Medical coding in healthcare is the process of converting complicated medical information into standardized codes that may be used for Medical billing and record keeping. Medical coding presents unique obstacles, even though it is critical for guaranteeing proper compensation and keeping a complete patient history. In this article, we’ll navigate through common […]
The federal No Surprises Act (NSA) has generated millions of complaints but serves to protect consumers from unexpected out-of-pocket healthcare costs, according to a new survey. AHIP, a U.S. health insurance trade group, and the Blue Cross Blue Shield Association (BCBSA) released a report that estimates the NSA prevents more than 1 million surprise bills […]
The CY 24 MPFS final rule last run the show was disseminated inside the November 16, 2023 Government Select. The run they appear addresses updated installment for specialist and other specialist administrations conjointly sets out unused rulemaking concerning certain other providers and things, such as ambulances, inquiries about offices and other demonstrative offices, and pharmaceutical […]