A lobbying onslaught from the health care industry nearly stopped Congress from passing a nationwide ban on “surprise” medical bills last year. Now, the same powerful groups are racing to sway federal agencies tasked with making the new law work — with billions of dollars and promised patient protections on the line. Health groups and […]
Medicare Radiology Payment System approach to advanced imaging reimbursement has been “dysfunctional” for decades, but health policy experts have a few suggestions to fix it. Over the past 20 years, the federal payment program witnessed “substantial” increases in the performance of MRIs, CT scans and nuclear studies, mostly in doc offices. A shift later […]
As promised, this is a follow-up to our first blog post on the new federal transparency requirements. In our prior post, we summarized the Hospital Price Transparency rule which went into effect on January 1, 2021, and here we discuss the transparency rules contained in the Consolidated Appropriations Act, 2021 (the “Act”), which apply to both health plans […]
CMS recommends that organizations review the agency’s most recent guidance on telehealth billing. CMS is reminding providers to ensure that Medicare claims for telehealth are correctly billed. The agency issued broadly expanded telehealth services as part of its response to the COVID-19 public health emergency. However, a 2018 Office of Inspector General audit found that CMS […]
The healthcare sector is in urgent requirement of an AI solution that can process a massive amount of data without compromising the speed and accuracy of billing. Medical billing and coding is a critical component of healthcare. The medical billing outsourcing market alone is estimated to reach $16.9 billion by 2021. The coding and billing […]
Physicians in a hospital’s emergency department (ED) collected significantly more of the charged amount for likely surprise medical bills compared to other patient cases, a new study in Health Affairs reveals. In the event of a likely surprise medical bill, physicians collected 65 percent of the charged amount compared with just 52 percent for other cases. Researchers also […]
In the realm of medical billing and coding, the incorporation of artificial intelligence stands as a pivotal advancement. Its role in healthcare establishments is to optimize billing procedures, thereby mitigating costly errors. Among the array of AI-driven technologies, machine learning and Natural Language Processing (NLP) take the forefront. These tools excel at swiftly and accurately […]
Radiology practices that perform interventional procedures have to be up to date on the use of documentation and coding techniques for evaluation and management (E/M) services. Since these current procedural terminology (CPT) codes in the 99xxx range are less commonly utilized in many radiology practices, identifying circumstances where E/M services are billable and then properly […]
A bill introduced last week in the House of Representatives could extend the moratorium on Medicare sequestration. The moratorium, which prevents a 2 percent Medicare cut, is scheduled to end March 31, but House Bill 1868, introduced March 12, would extend that deadline until Dec. 3. The bill currently has been referred to a […]
This new law is set to take effect on Jan. 1, 2022. In the closing days of 2020, Congress enacted and the President signed into law the “No Surprises Act.” But what does that mean for providers and patients exactly? The Act contains key protections to hold consumers harmless from the cost of unanticipated […]