Category: Medical Billing

2024-Medicare-OPPS-Rule

2024 Medicare Outpatient Prospective Payment System Proposed Rules

The OPPS proposal lacked any mention of several prominent issues that industry leaders have eagerly awaited reforms on. Yesterday, federal officials introduced two sets of proposed rules, which included possible revisions to the Medicare Physician Fee Schedule (PFS) and Outpatient Prospective Payment System (OPPS) for the 2024 calendar year. Within the PFS proposed rule alone, […]
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Surprise Medical Billing

President’s Efforts to Limit Surprise Medical Bills and Reduce Health Care Expenses

The President administration has announced its intention to restrict the sale of “junk” insurance policies, including short-term plans that may not provide adequate coverage for individuals who are in-between jobs and require temporary health care coverage. These policies have been known to deny basic coverage to policyholders. On Friday, President announced a set of fresh […]
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Proposed Home Health Payments

CMS Proposed Payment Cut to Home Health Agencies

Part of the reason for the decrease is attributed to a permanent adjustment in behavior assumptions. The 2024 Home Health Prospective Payment System Rate Update proposed rule released on June 30 revealed that Home Health Agencies will experience a 2.2% payment decrease in 2024 compared to 2023, partly due to a permanent behavior assumption adjustment. […]
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Outsourced Medical Billing Services

How Outsourced Medical Billing Services Improve Your Bottom Line

Outsourcing medical billing services can be an effective strategy to improve the financial health of your healthcare practice. By delegating the billing and coding tasks to a specialized third-party provider, you can streamline your revenue cycle, reduce administrative burdens, and enhance your profitability. However, medical billing can be a complex and time-consuming task that requires […]
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Bill Minor Procedure

How to Bill an E/M With a Minor Procedure

To determine the appropriate use of modifier 25, review this case study in otolaryngology. The Cigna Group has delayed the requirement for submitting documentation with claims that involve a 25 modified offices or other outpatient evaluation and management (E/M) service (CPT® 99212-99215) and a minor procedure. Despite the payer not enforcing this requirement, physician practices […]
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Telehealth Rule Changes

Congress Backs Permanent Telehealth Rule Changes

A new bill pending in Congress could make permanent the telehealth changes that proved beneficial to physicians and patients during the COVID-19 pandemic. Additionally, a leading physician group is now backing site-neutral payment for medical services. These two topics have recently been the subject of renewed discussion due to proposals by federal policy makers. CONNECT […]
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Top Trends That Impacts Medical Billing Space

Medical coding and medical billing are two distinct yet interrelated tasks in the healthcare industry. Coding is the process of assigning standardized codes to diagnoses and procedures, while billing is the process of submitting claims to insurance companies for reimbursement. One of the biggest challenges in the medical billing space today is the shortage of […]
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Medical Billing Strategies

4 Strategies to Optimize Billing and Expand Your Customer Base

The increasing demand for incontinence products is prompting home medical equipment (HME) providers to reevaluate their existing incontinence programs. With the U.S. witnessing a significant rise in the aging population, marked by 10,000 people turning 65 every day according to the U.N. Population Division, there is a growing market for incontinence products. Studies from Mayo […]
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Financial-Impact-of-Delayed-Medical-Billing

Accelerating Revenue: Revealing the Financial Impact of Delayed Medical Billing

The impact of prolonged turnaround times from billers in medical billing is frequently underestimated, yet it has far-reaching consequences for everyone involved. Delays in processing times impose financial burdens on healthcare organizations and patients. By gaining insight into the concealed costs and inefficiencies, we can enhance the process and achieve more favorable financial outcomes. In […]
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artificial intelligence hospital billing

How AI Empowers Hospital Bills with Complete Medical Records

According to the CEO of a prominent healthcare IT consulting firm, hospitals face significant financial losses due to billing inaccuracies, estimated to be in the billions annually. However, the implementation of physician-trained artificial intelligence can assist hospitals in recovering millions of dollars by reducing denials and improving revenue recovery processes. The CEO of a prominent […]
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