The emphasis on preventive care by the payer likely contributed to its high re-enrollment rate. Insurance Company’s employer-sponsored healthcare plan, compliant with the Affordable Care Act, has emerged as the fastest-growing commercial plan for the payer. Data from the payer’s Impact Study suggests that the healthcare plan company’s focus on both price transparency and preventive […]
In the intricate realm of healthcare, where patient well-being is paramount, the financial dimension often receives less attention. Yet, it’s imperative to recognize that healthcare encompasses not only patient treatment but also ensuring fair compensation for healthcare providers. Precise medical coding is a cornerstone of this endeavor. This piece delves into the profound importance of […]
The fiscal year 2024 ICD-10-CM codes have recently become active, and they will have an impact on your reimbursement. Earlier this year, CMS announced the incorporation of 395 fresh diagnosis codes, removal of 25 codes from the diagnosis set, and modification of 13 codes— all of which became effective on October 1. A substantial portion […]
Higher satisfaction with problem resolution was observed among beneficiaries who were more inclined to renew their Medicare Advantage plan. Medicare Advantage plans have garnered favorable satisfaction scores, with beneficiaries showing high approval ratings for trustworthiness, operational ease, and coverage adequacy, as outlined in a recent market research study. The 2023 US Medicare Advantage Study encompasses […]
A recent study conducted by a leading professional services firm revealed that the anticipated expenses borne by U.S. employers for their workforce’s healthcare will see a notable uptick of 8.5%, surpassing $15,000 per employee. This surge, assuming companies do not introduce augmented employee contribution methods or alternate cost-reducing strategies, stands almost twice as high as […]
The 2024 physician fee schedule (PFS) proposed rule has been released by the Centers for Medicare & Medicaid Services (CMS). Within this rule, remote physiologic monitoring (RPM), also known as remote patient monitoring, has garnered significant attention. While customary for a proposed rule, CMS has introduced several suggested modifications to RPM. However, what sets this […]
Since the launch of OpenAI’s ChatGPT last year, healthcare executives have been actively discussing the potential of artificial intelligence in healthcare. The technology is constantly advancing, and health systems are closely monitoring its applications for maximum benefits. Microsoft is said to be working on a healthcare-oriented version of ChatGPT that prioritizes privacy, and they have […]
CPT code 99214. Is that Jean Valjean’s number? No. It is an evaluation and management (E&M) code of moderate complexity. Few CPT® codes cause goosebumps, a chill in the air, and a pit in your stomach besides CPT code 99214. It is an E&M code of moderate complexity. For a low-complexity visit, the code decreases […]
Average payments are $58,000 for small providers, $289,000 for medium providers, and $1.7 million for larger providers. The U.S. Department of Health and Human Services, through the Health Resources and Services Administration (HRSA), said it’s distributing about $9 billion in Provider Relief Fund payments to providers, with a particular focus on smaller providers. This is […]