With over 67 million Americans—nearly 20% of the population—relying on Medicare, the program plays a crucial role in ensuring access to quality healthcare. Unfortunately, looming Medicare physician reimbursement cuts threaten to undermine this vital service, potentially leading to reduced access to care and compromised patient outcomes Medicare physician reimbursement cuts, such as the proposed 2.8% […]
Healthcare fraud in medical coding, particularly through practices like upcoding and unbundling, has become a major concern for medical coding and billing professionals. A recent healthcare market research survey found that 90% of respondents view upcoding as a significant ethical challenge Upcoding involves assigning higher-level codes to medical services than are warranted, leading to inflated […]
Most Americans prefer the convenience of direct deposit for their paychecks. However, imagine if your employer deducted a 2-5% fee from each paycheck to cover the cost of electronic payments. While it seems absurd, this is the reality for many doctors in the U.S. Healthcare insurers and their payment processors often impose hidden EFT fees […]
Providers and coders should work together to maximize reimbursement by ensuring accurate coding, which is validated by thorough medical documentation. By focusing on ways to improve medical documentation for better reimbursement, providers can enhance patient care and ensure accurate reimbursement. Here are five ways to improve documentation, patient care, and reimbursement: 1. Avoid EHR Shortcuts […]
A new survey reveals a significant rise in cyberattacks on healthcare organizations since 2023. These attacks have led to substantial disruptions in patient care, with the average attack costing organizations nearly $1.5 million. According to the survey, 92% of healthcare IT and security professionals reported at least one cyberattack in the past year, up from […]
The U.S. Department of Health and Human Services (HHS) recently announced a $250,000 settlement with a Washington-based healthcare provider for alleged HIPAA violations. The violation stemmed from a ransomware attack and subsequent investigation by the HHS Office for Civil Rights (OCR) Ransomware Attacks and HIPAA Compliance: Protecting Patient Data: This settlement highlights a growing concern […]
Healthcare providers face a rising tide of Healthcare cyberattacks, which can have devastating consequences. These attacks are becoming more frequent and costly, and healthcare organizations are spending more than any other industry to recover from them. Small Practices at Risk: Small healthcare providers are particularly vulnerable to Healthcare cyberattacks due to limited resources and staff. […]
Prior Authorization for Spinal Neurostimulator Implantations: The Centers for Medicare & Medicaid Services (CMS) implemented a prior authorization requirement for spinal neurostimulator implantations surgeries on July 1, 2021. This policy change took effect after the Office of Inspector General (OIG) had concluded its field work but before the release of its investigation report. CMS specifically […]
The healthcare industry has long been burdened with paperwork, from patient intake forms to insurance documentation. While many healthcare providers have already adopted Electronic Medical Records (EMRs), there’s a growing realization that going paperless can extend far beyond just digitizing patient records. One significant area where healthcare can continue to evolve is through the use […]
Medicare coverage is the federal health insurance program for Americans 65 and older, as well as younger individuals with long-term disabilities. It covers a wide range of medical services, including hospitalizations, doctor’s visits, prescription drugs, and specialized care like skilled nursing, home health, hospice, and preventive services There are two primary ways to receive Medicare […]