The final rule is an implementation of the No Surprises Act, which was passed by Congress last year. The U.S. Department of Health and Human Services issued an interim final rule this week banning surprise medical bills and some out-of-network charges, which will go into effect on January 1, 2022 for providers and insurance […]
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 […]
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 […]
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 […]
For several, it is hard to envision the future of Revenue Cycle Management (RCM) in the Artificial Intelligence (AI) era. How does this technology accelerate the business cycle and affect healthcare back-office day-to-day work? It is unknown when AI will be the industry norm at this stage, but there is some speculation about potential advantages […]
By April of last year, seemingly every news station in American was featuring the heroic efforts of physicians, nurses, and other clinicians fighting COVID-19. These providers transformed healthcare, implementing telehealth and virtual care, standing up new wards in hotels, sports arenas, and schools, and finding new ways to stretch precious supplies. But behind those transformations […]