Category: Blog

payer-strategies-and-the-long-road-to-payment

Payer Strategies and the Long Road to Payment

The average cost of debunking a denial is $25 per claim, not to mention the continuous challenges associated with attaining timely payment. Reviewing denial management strategies on a regular basis may prove a more efficient payment journey. Claim denials are a continuous challenge for the healthcare industry, as providers struggle with write-offs and the resources […]
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cms-issues-2023-ipf-pps-proposed-rule

CMS Issues 2023 IPF PPS Proposed Rule

  Provisions include topsy-turvy payment adjustments across the country. A proposed rule outlines payments, wages, and policies in fiscal year (FY) 2023 for inpatient psychiatric facilities paid under the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS). The Centers for Medicare & Medicaid Services (CMS) issued the proposed rule March 31 and is accepting public […]
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4-ways-to-improve-claims-efficiency-for-rural-providers

4 Ways to improve claims efficiency for rural providers

The Centers for Medicare & Medicaid Services (CMS) subsidizes healthcare in defined rural environments, paying encounter rates for provided services provided and the overhead required to provide them. However, it’s not free money. Rural health clinic (RHC) leaders must keep track of the services provided and submit yearly totals. They also must submit and process […]
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cms-assess-telehealth-quality-medicaid-beneficiaries

Government Accountability Office asks CMS to assess telehealth quality for Medicaid beneficiaries

The U.S. Government Accountability Office is asking the Centers for Medicare and Medicaid Services to gauge the effect that an increase in telehealth utilization is having on the care quality experienced by Medicaid beneficiaries. The GAO cited statistics showing usage continues to rise. GAO culled data from five states – Arizona, California, Maine, Mississippi and […]
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5-tax-traps-physicians-should-avoid

5 Tax traps physicians should avoid

With Tax Day on the horizon, don’t fall into these specific traps. Our last installment provided some details and basic rules every doctor should know about tax planning, including who is responsible for the information on your tax return, details about what income you have to report, and a look at the sales techniques promoters […]
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get-to-the-heart-of-coding-tavr

Get to the Heart of Coding TAVR

Solidify your understanding of aortic valve disease and how to report this life-changing treatment. Transcatheter aortic valve replacement (TAVR) is a minimally invasive cardiac procedure to replace a diseased aortic valve in a person’s heart. The most common reason to undergo TAVR is aortic stenosis, which is an abnormal narrowing of the aortic valve opening […]
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new guidelines for billing splitshared visits

Updates Clarify Medicare Split/Shared Billing

Know the facts for ensuring proper payment of these claims in 2022. New policy for split/shared evaluation and management (E/M) visits (including critical care services and prolonged services) was finalized in the calendar year (CY) 2022 Medicare Physician Fee Schedule (MPFS) final rule. Knowing the new guidelines for billing split/shared visits performed in the facility […]
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