Category: Medical Billing

Value-based-revenue-on-primary-care-income

Value-Based Revenue Makes up 6.74% of Primary Care Income

MGMA report shows value-based contracts account for $30,922 per provider The Medical Group Management Association released a report looking at the proliferation of value-based contracts and how quality metrics tie-in to revenue. The report, 2022 MGMA DataDive Practice Operations, shows that revenue from value-based contracts accounted for varying amounts of total medical revenue in 2021 […]
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Locum-Tenens-Physicians-to-fill-vacant-positions

Locum Tenens Physicians To Fill Vacant Positions

  Hospitals are increasingly utilizing locum tenens physicians, advanced practice providers (APPs), and telehealth services to address staffing shortages. The Innovation & Flexibility: Journey to Sustainable Healthcare Report reflects data from 129 healthcare administrators representing a range of facility types and sizes. The COVID-19 pandemic exacerbated hospital staffing shortages as many clinicians faced burnout and […]
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CMS IPPS Rule

IPPS Final Rules update for Medicare payments for 2023

CMS has published the Fiscal Year 2023 (Oct 1, 2022) final rules for Medicare payments. The major rule is, of course, the inpatient hospital prospective payment system (IPPS) and long-term care hospital (LTCH) PPS rule. The final rule, as reported by Stanley Nachimson, contains several payment and quality program changes that go into effect Oct […]
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Cancer Centers Fail to Comply with Hospital Price Transparency Rule

Cancer Centers Fail to Comply with Hospital Price Transparency Rule

Failing to post files in a machine-readable format was the most common violation of the hospital price transparency rule among NCI-designated cancer centers. Less than one-third of hospitals with National Cancer Institute (NCI) cancer center designation were fully compliant with the CMS hospital price transparency rule, according to research published in JAMA Surgery. The price […]
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medicare-suspends-prior-authorization-requirements-for-some-dme

Medicare Suspends Prior Authorization Requirements for Some DME

Prior authorization is no longer required for certain DME when it risks the health of the patient. The Centers for Medicare & Medicaid Services (CMS) has suspended the prior authorization requirements for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when waiting for prior authorization would delay healthcare and risk the life or health […]
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Recession-Proofing-Strategies-for-Independent-Practices

Top Recession-Proofing Strategies for Independent Practices

More than half of economists agree that the U.S. economy is headed for a downturn. Contrary to popular belief, the healthcare sector has never been recession-proof. Reports indicate that the healthcare industry is affected later in a recession and has a longer recovery period. Compared to other healthcare facilities, like hospitals and emergency rooms, independent […]
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Coding Drives Up Medical Billing Costs in the US

Coding Drives Up Medical Billing Costs in US

Another study confirms that medical billing costs in the US significantly exceed those in similar countries, but researchers now know why: coding drives up US administrative spending. Complex coding structures in the US are driving up medical billing costs in the US, making it one of the most expensive countries to get paid, according to […]
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New-Appeal-Rights-for-Patients

CMS Announces New Appeal Rights

Appeal rights appear much narrower than many expected. Earlier this year, a federal appeals court issued an opinion on Barrows v. Becerra, a long-running class action lawsuit. Filed by a group of Medicare beneficiaries, the suit alleged they had to pay out of pocket for skilled nursing care—despite being hospitalized for over three days—because their […]
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