Category: Medical Billing

Survey: High Initial Claim Denials Impact Healthcare Providers

Survey: High Initial Claim Denials Impact Healthcare Providers

The Rising Denial Rates in Healthcare Claims Processing Initial Claim Denials: In a new survey conducted by healthcare Company an increased percentage of initial claims are denied by private payers, including pre-approvals for medical claims. Hospitals, health systems, and post-acute care providers may have a difficult time getting paid for medical services. The survey respondents […]
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Medicare Conversion Factor Increases, But Payments Remain Lower

Medicare Conversion Factor Increases, But Payments Remain Lower

Medicare Conversion factor are up but payouts are still down compared to last year. Healthcare professionals will see a slight upward adjustment to their Medicare payments starting March 9 after President Biden signs the Consolidated Appropriations Act (CAA), 2024.  Really fortunately, although the 2024 CAA increases the conversion factor (CF) finalized for calendar year (CY) […]
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Remote patient monitoring: pros and cons

Remote Patient Monitoring (RPM): Transforming Healthcare

Healthcare providers are increasingly recognizing the transformative potential of Remote Patient Monitoring (RPM). This technology offers significant benefits, including improved patient outcomes, reduced healthcare costs, and the ability to deliver personalized, patient-centered care while easing provider workload. This widespread recognition is fueling substantial investment, with the RPM market projected to experience a 3.3% compound annual […]
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The Impact of CMS-0057-F on Streamlining Prior Authorization Processes

Interoperability & Prior Authorization Final Rule: Impact on US Healthcare

The healthcare landscape in the United States is poised for a significant transformation with the implementation of the Interoperability and Prior Authorization Final Rule (CMS-0057-F). This landmark rule, finalized by the Centers for Medicare & Medicaid Services (CMS) on January 17, 2024, directly tackles the often-cumbersome prior authorization process, aiming to alleviate administrative complexities for […]
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Medicare Billing Update: Boost Reimbursement with G2211 Add-On Code

Medicare Billing Update: Boost Reimbursement with G2211 Add-On Code

To capture Medicare reimbursement for complex Medicare patient visits, you must know when to use this G2211 Code add-on code. To report the additional time, effort, and related practice expenses associated with caring for Medicare patients across the continuum of care, qualified healthcare providers can begin billing HCPCS Level II codes on Jan. 1, 2024. […]
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Medicare CY 2024 Proposed Rule: Impact, Reimbursement Changes, and Key Insights

Medicare CY 2024 Proposed Rule: Impact, Reimbursement Changes, and Key Insights

On July 13, Medicare released its Proposed Rule, which outlined changes to different Medicare programmes including as quality programmes, MIPS, rural employment, telemedicine, and others. This comprehensive yearly document of 2,033 pages covers the planned programme adjustments for fiscal year 2024. Between the release of the Draft Rule and the publishing of the Final Rule […]
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