Category: Medical Billing

Providers Support Value in Health Care Act that Amends MACRA Payment Model

Providers Support Value in Health Care Act that Amends MACRA Payment Model

Among other provisions, the bill extends the 5% advanced APM bonus for an additional six years and modifies thresholds to achieve the bonus. Thirteen national provider groups support the newly-introduced House bill, the Value in Health Care Act of 2020, a bipartisan effort that proposes to make changes to the Medicare Access and CHIP Reauthorization Act (MACRA) […]
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How a Pandemic Impacts HIPAA Requirements

How a Pandemic Impacts HIPAA Requirements

As healthcare business professionals, we have been trained in the importance of following HIPAA privacy and security requirements. As coders, auditors, and health information services professionals we are bound by the HITECH Act of 2009, which outlines the responsibilities of “business associates” with respect to HIPAA requirements. As business associates, we are required to “appropriately […]
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Post COVID-19_ Medical Billing Finally Realizes the Value of Text-to-Pay

Post COVID-19: Medical Billing Finally Realizes the Value of Text-to-Pay

Contactless payments were on the rise even before COVID-19 hit. But now, health systems should see them as essential. Consumers are increasingly wary of touching a credit card terminal that others have used, a perfect conduit for spreading germs. For consumers, text payments serve as a convenient contactless way to pay, but there are other unique benefits […]
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Labs Welcome CMS Rate for Coronavirus Antibody Testing

Labs Welcome CMS Rate for Coronavirus Antibody Testing

CMS set the reimbursement rate for Medicare Administrative Contractors covering the main type of coronavirus antibody test at approximately $42, per an update Tuesday. That rate exceeds investment firm William Blair’s $25 estimate for the category of tests, boding well for future reimbursement policy for antigen testing, analysts noted. Last month, the agency doubled its reimbursement for high-throughput molecular […]
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4 Critical Attributes of A COVID-19 Billing And Coding Workbook

4 Critical Attributes of A COVID-19 Billing And Coding Workbook

  Our goal was to develop a single source of truth that is user-friendly, dynamic, and easily accessible,” said Jeannette Wood, vice president of revenue cycle management for Privia Health. A rapidly changing situation like the COVID-19 pandemic calls for a dynamic solution for tracking billing and coding changes for virtual services from different payers […]
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COVID-19 Reimbursement

Safeguarding COVID-19 Reimbursement

Waivers, modifiers, lab tests, multiple diagnosis codes…the layers and specifics of COVID-19 coding cannot be overlooked when ensuring appropriate reimbursement and safeguarding claims against third-party payer audits. As hospitals and healthcare organizations begin to assess the required steps necessary to prepare for the transition back to a pre-COVID-19 operating environment, apart from timelines and state […]
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Patient-Friendly Medical Billing to a COVID-19 World

Adapting Patient-Friendly Medical Billing to a COVID-19 World

Monument Health in South Dakota is adapting to a new definition of patient-friendly medical billing as COVID-19 transforms patient needs and their ability pay for healthcare. Patient financial responsibility has been impacting the hospital revenue cycle far before the world knew what COVID-19 was. But the unprecedented public health crisis has shed new light on patient-friendly […]
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Medical Billing for Telehealth During COVID-19

Medical Billing for Telehealth During COVID-19

COVID-19 is changing the way we practice medicine. Social distancing measures have led to a surge in demand for telemedicine, while practices around the country are seeing a reduced number of in-office patient visits. While the regulatory environment has not always been favorable towards telehealth, federal and state legislations have recently loosened in an effort […]
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New Billing Basics for Telemedicine

New Billing Basics for Telemedicine

Betsy Nicoletti, MS, a nationally recognized coding expert, will take your coding questions via email and provide guidance on how to code properly to maximize reimbursement. Have a question about coding? Send it here. In this column, Nicoletti outlines some key guidance for using telemedicine. These rules would apply during the Centers for Medicare & Medicaid […]
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