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 […]
During the Healthcare debate between Vice President Kamala Harris and former President Donald Trump, healthcare—especially the Affordable Care Act (ACA)—became a central focus in the final stages of the discussion. Moderated by journalists Linsey Davis and David Muir, the Healthcare debate showcased starkly different perspectives on the future of the ACA. Trump’s Unclear Healthcare Plan: […]
Medicare changes in 2025 marks a significant year for Medicare beneficiaries as the program undergoes its most substantial changes in decades. The Inflation Reduction Act has introduced several key reforms aimed at lowering prescription drug costs and improving overall coverage. 1. Out-of-Pocket Drug Costs Capped at $2,000 A major highlight of the Medicare changes in […]
Medicare payment cut: The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule for the 2025 Medicare Physician Fee Schedule (MPFS), which includes a 2.93% average payment rate reduction for physicians. This comes despite the agency’s stated commitment to advancing health equity and supporting whole-person care through initiatives like strengthening primary care […]
The CPT code set for 2024 has recently been released. The modifications discussed below pertain specifically to urology and will become effective on January 1, 2024, across all payers. While pricing and coverage details will be finalized for certain procedure codes, primarily for Medicare, with the release of the Medicare Physician Fee Schedule in late […]
The medical billing process is a complex system that requires various steps to ensure accuracy and efficiency. Medical billing services work hard to make sure that medical bills are processed quickly and accurately, allowing for timely payments from insurance companies. 1. Patient Registration The medical billing process begins with patient registration, where the patient’s demographic […]
ESRD PPS 2025 Update: In the July 5 Federal Register, the Centers for Medicare & Medicaid Services (CMS) will publish a proposed rule for the calendar year (CY) 2025 End-Stage Renal Disease Prospective Payment System (ESRD PPS). A number of changes to Medicare policy and payment rates for ESRD facilities are included in the rule. Changes […]
HIPAA violations happen when a healthcare organization fails to follow the Health Insurance Portability and Accountability Act (HIPAA) rules. HIPAA is a law that protects patients’ privacy by setting standards for securing and sharing their medical information. There are different ways a HIPAA violation can occur, but they often involve a patient’s protected health information […]
2024 CPT Coding updates: Take a look at the updates in CPT coding and guidelines for professional services. Every year, on January 1st, updated CPT® codes and coding guidelines emerge, introducing new, revised, and eliminated codes. For instance, in CPT® 2024, there are 230 new codes, 70 revised ones, and 49 removed codes. Notably, no […]
The US health care system, one of the best in the world, with qualified doctors trained in world medical schools, faces a major flaw: reduce medical errors, which cause about 1 in 1 10 Americans died and cost the country $20 billion age. Almost 2 out of 3 of these errors are based on poor […]