Category: Blog

10-Steps-Will-Help-You-Prevent-Denials

10 Steps Will Help You Prevent Denials

Healthcare policies and rules are continuously changing, and it’s important to stay on top of what all insurance carriers are doing and how their changes impact your practice’s revenue cycle. This, as well as managing your accounts receivable (A/R), is the best way to ensure your cash flow does not bottleneck and cause damage to […]
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Intricacies-of-the-2021-EM-Coding-Guidelines

Intricacies of the 2021 E/M Coding Guidelines

Industry experts explain the intricacies of the 2021 E/M coding guidelines. During the Evaluation and Management (E/M) Panel general session, an expert panel made up of a physician, coder, auditor, payer, and a representative from the American Medical Association (AMA) answered audience questions regarding the 2021 E/M coding guidelines for office/outpatient visits. The panelists were […]
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Value-based-care-catching-up-to-FFS

Value-Based Care Catching up to Fee-For-Service

Outcomes-based models are spreading, but fee-for-service still dominates payment landscape. Is value-based care having a moment? Health care policy experts and institutions have long agreed that fee-for-service (FFS) medicine is wasteful, outmoded and at least partially responsible for the U.S. spending far more than peer nations on health care, but with outcomes that are no […]
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Medicare-Overpayments-to-Hospitals

CMS System Edits Reduced Medicare Overpayments to Hospitals

Medicare overpayments totaled $39.3 million between September 2016 and December 2021, but most of those improper payments occurred before CMS corrected its system edits error in May 2019. CMS system edits helped reduce Medicare overpayments to acute care hospitals for outpatient services provided to beneficiaries who were inpatients of other facilities, a report from the […]
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Potential-Medicare-Payment-Cuts-for-2023

The potential Medicare payment cuts for 2023

The potential Medicare payment cuts for 2023 reflect the proposed 4.5 percent decrease in the Medicare conversion factor and the 4 percent PAYGO sequester. As medical groups expect to see Medicare payment cuts in 2023, practices are considering limiting the number of new Medicare patients and reducing clinical staff to ensure financial stability, according to […]
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Outpatient-and-Inpatient-Consultation-Services

Outpatient and Inpatient Consultation Services can be Tricky

The AMA updated consultation services for 2023. The American Medical Association (AMA) announced major revisions to Evaluation and Management (E&M) Services for Jan 1, 2023. The E&M categories that will undergo revision in 2023 include inpatient and observation care services, emergency department services, consultations, nursing facility services, home and residence services, and prolonged services. Revisions […]
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Hospital-Expenses-Since-2016

Hospital Expenses Have Increased 23 Percent Since 2016

Supply chain issues, medication costs, and labor challenges sparked by the COVID-19 pandemic have contributed to the spiking hospital expenses. Hospital expenses have increased 23 percent since 2016, a spike researchers attributed to continuous COVID-19 challenges, according to a recent analysis. By analyzing American Hospital Association data, investigators noticed hospital expenses increased 47 percent in 2020when […]
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Telehealth-Policy-After-the-Pandemic

What’s Ahead For Telehealth Policy After the Pandemic

Federal and state advocacy team members discussed the status of telehealth policy as the public health emergency deadline looms and the industry questions, ‘Is the pandemic over?’ The American Telehealth Association is working with Congress and several federal agencies to shape the fate of policies and payments for telehealth services that experienced a rapid uptake […]
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