Category: Healthcare News

CMS Proposes Changes to Physician Fee Schedule, Quality Payment Program

CMS Proposes Changes to Physician Fee Schedule, Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) is proposing changes to the Medicare Physician Fee Schedule (PFS) and the Quality Payment Program as part of its effort to reduce provider burden. “Clinicians are drowning in paperwork and reporting requirements caused by cumbersome government rules and regulations,” said CMS Administrator Seema Verma in a press […]
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Effective And Profitable Chronic Care Management

How To Deliver Effective And Profitable Chronic Care Management

Chronic care management (CCM) has an overarching clinical goal—improving the health of Medicare patients with multiple chronic conditions. Besides knowing the service parameters, pay rates and usage requirements for CCM codes, physicians must understand how to effectively bill for CCM in order to profitably achieve that goal. Medicare pays for CCM (typically, non-face-to-face) services to […]
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Using Artificial Intelligence To Advance Revenue Cycle Management

Using Artificial Intelligence To Advance Revenue Cycle Management

Artificial intelligence (AI) is making big waves in healthcare from detecting lung cancer and gene mutations that lead to autism to addressing social determinants of health and chronic conditions. The technology is automating and optimizing clinical workflows, leading to improved outcomes, lower costs, and enhanced patient and provider satisfaction. The critical role artificial intelligence now plays in healthcare prompting some providers to […]
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Medicare Beneficiary Identifiers

The New Medicare Cards: What You Need to Know About Medicare Beneficiary Identifiers (MBIs)

To protect the privacy of Medicare recipients and prevent fraudulent use of Social Security Numbers (SSN), a new, unique 11-character Medicare Beneficiary Identifier (MBI) is replacing the SSN-based Health Insurance Claim Number (HICN) for Medicare transactions such as billing, eligibility status, and claim submissions. The MBI does not change Medicare benefits. What’s Behind The Change? The […]
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Medicare Advantage

Medicare Advantage Dual Eligible’s Have Fewer ER Visits Than Those Under FFS

Dual eligible Medicare Advantage beneficiaries had 42.1% less emergency room visits than their fee-for-service counterparts. The cost of care and rate of hospitalizations for dual eligible Medicare Advantage (MA) beneficiaries was considerably lower than dual eligibles under fee-for-service (FFS), according to an Avalere Health study released Tuesday evening. Dual eligible Medicare Advantage (MA) populations averaged healthcare […]
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Healthcare Remains Primary Concern for Voters, with Strong Support For ‘Medicare-For-All’

Healthcare is a top priority for American voters and there aren’t dramatic differences by ideology, according to a new survey. Key Takeaways Thirty six percent of Americans ranked healthcare as the most important policy issue facing the nation’s future. Seventy two percent of Americans responded that they were satisfied with the healthcare they received while […]
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Providers Exempt

Are Providers Exempt From Information Blocking Backlash?

Keen on giving Americans in federally-funded programs more control over their healthcare, the U.S. Department of Health and Human Services (HHS) has been working closely with past and present administrations to establish regulations governing electronic health information (EHI). On March 4, the Office of the National Coordinator for Health Information Technology (ONC) published a proposed […]
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How AI Reshaping Hospital Revenue Cycle

How Artificial Intelligence, Analytics & Automation are Reshaping Hospital Revenue Cycle

The accelerating challenge around patient needs’ calls for new technology and automation, but on a personal level. As hospitals turn to technology to overhaul the patient experience and improve profits, a range of vendors are bringing new products and outsourced services to meet that demand with artificial intelligence, data analytics and natural language processing as […]
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Psychiatric Facilities

Psychiatric Facilities Could See Payments of $75 Million In 2020

CMS has released the inpatient psychiatric facility proposed rule. Approximately $75million is projected to be paid to inpatient psychiatric facilities (IPF), according to the Centers for Medicare & Medicaid Services (CMS) proposed 2020 inpatient prospective payment system (IPPS) released on April 19. IPF-PPS applies to inpatient services for psychiatric hospitals and distinct psychiatric units of […]
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