Category: Medical Billing

4-ways-to-improve-claims-efficiency-for-rural-providers

4 Ways to improve claims efficiency for rural providers

The Centers for Medicare & Medicaid Services (CMS) subsidizes healthcare in defined rural environments, paying encounter rates for provided services provided and the overhead required to provide them. However, it’s not free money. Rural health clinic (RHC) leaders must keep track of the services provided and submit yearly totals. They also must submit and process […]
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new guidelines for billing splitshared visits

Updates Clarify Medicare Split/Shared Billing

Know the facts for ensuring proper payment of these claims in 2022. New policy for split/shared evaluation and management (E/M) visits (including critical care services and prolonged services) was finalized in the calendar year (CY) 2022 Medicare Physician Fee Schedule (MPFS) final rule. Knowing the new guidelines for billing split/shared visits performed in the facility […]
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tread-carefully-in-medicare-billing

Tread Carefully in Medicare Billing

Thanks to new provisions that went into effect for the 2022 calendar year, CMS is no longer necessarily considering “nefarious intent” when determining whether a provider or supplier should be excluded from the Medicare program. The Physician Fee Schedule for the 2022 calendar year is in full effect. The proposals, which were issued in July […]
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hospitals-saw-substantial-underbilling-for-medicare-telestroke-services

Hospitals Saw Substantial Underbilling for Medicare Telestroke Services

One-third of hospitals across the country offered telestroke services, but less than 40 percent submitted Medicare telestroke claims in the year before the COVID-19 pandemic. Following the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare claims for telestroke services increased in rural and urban emergency departments. However, there was still substantial underbilling from hospitals with […]
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Telehealth Utilization Increasing Medicaid Provider Reimbursement

Telehealth Utilization Increasing Medicaid Provider Reimbursement

Not only has Medicaid ensured care access for enrollees during the pandemic, but its coverage of telehealth services has proved a boon to Medicaid providers in California. Increased use of telehealth services by Medicaid beneficiaries in California is leading to positive financial outcomes for providers in the state. CLOSEDLOOP.AI TOPS EPIC, CERNER FOR AI PLATFORM […]
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cms-releases-no-surprises-act-state

CMS Releases No Surprises Act State Enforcement Letters

During a National Stakeholder Call on January 18, 2022, Ellen Montz—Deputy Administrator and Director of the Center for Consumer Information and Insurance Oversight (CCIIO) at the Centers for Medicare and Medicaid Services (CMS)—announced that CMS had begun publishing state-specific letters (the “Enforcement Letters”) detailing anticipated Federal and state responsibilities with respect to enforcement of the […]
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