Category: Revenue Cycle Management

Biden Administration Shares Latest Round of HHS Staff Appointments

Biden Administration Shares Latest Round of HHS Staff Appointments

Today the Biden Administration announced its latest group of appointments to the Department of Health and Human Services. The new appointees join tens of thousands of career officials throughout the agency at a time when expertise is critical to tackling the ongoing COVID-19 pandemic. WHAT’S THE IMPACT? Kristina Schake will serve as HHS Secretary Xavier Becerra’s […]
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New Medicare Rule Will Cut Payments to Hospitals for Some Surgeries

New Medicare Rule Will Cut Payments to Hospitals for Some Surgeries

A cost-cutting change in Medicare policy will reduce payments to hospitals for some surgical procedures and increase costs for patients, according to a March 21 report from the The Washington Post. Before the change, CMS categorized 1,740 surgeries and other services as eligible for Medicare payments only if they were performed on beneficiaries who were admitted […]
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Biden Administration Invests in Expanding COVID-19 Testing and Treatments

Biden Administration Invests in Expanding COVID-19 Testing and Treatments

The U.S. Department of Health and Human Services is releasing new funding aimed at helping schools reopen and to expand access to COVID-19 testing and treatments among underserved populations. On Wednesday, HHS made two funding announcements – to invest more than $12 billion to expand COVID-19 testing, as well as $150 million to increase access to monoclonal antibody therapeutic treatments […]
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April Updates Bring HCPCS Changes

April Updates Bring HCPCS Changes

Make sure you’re using the latest code files for your Medicare claims. A second quarter update to the HCPCS Level II code set used for reporting products, supplies, and services adds 23 codes. Additionally, six codes are revised and 12 are discontinued, effective April 1, 2021. There are also two codes with changes to Medicare coverage. […]
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MA Reimburses 2X Medicare Rate for Some COVID-19 Vaccinations

MA Reimburses 2X Medicare Rate for Some COVID-19 Vaccinations

Healthcare providers in Massachusetts are getting twice the standard Medicare rate for COVID-19 vaccinations in an effort to accelerate vaccine rollout, according to a recent provider bulletin from the state’s Medicaid office. The provider bulletin released in January 2020 states that providers administering the two-dose vaccines from Pfizer and Cambridge, Massachusetts-based Moderna will receive $33.88 for the […]
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CMS Issues Reminder on MSP Billing Rules, Appeal Options

CMS Issues Reminder on MSP Billing Rules, Appeal Options

  CMS is reminding organizations of Medicare Secondary Payer (MSP) billing and appeal processes after the agency inappropriately denied some claims. Organizations are advised that they must continue to provide services to patients who have open or closed secondary payer records on file or if Medicare inappropriately denied a claim, according to MLN Matters SE21002. Organizations are […]
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CMS Moves to Streamline Coverage and Reimbursement for COVID Testing and Vaccination

CMS Moves to Streamline Coverage and Reimbursement for COVID Testing and Vaccination

Federal officials are ordering plans and insurers to cover testing without cost-sharing – for virtually any purpose. Federal officials have issued new guidance intended to streamline the process through which Americans can get easy, free access to COVID-19 diagnostic testing and/or vaccinations. “This guidance makes clear that private group health plans and issuers generally cannot […]
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Advancements in Automation Are Cutting Into the Rising Costs of Manual Healthcare Transactions

Best Practices to Ensure Telehealth Security and Protect Patient Data

  To support the sudden increase in test results and medical records being transmitted during the pandemic, hospitals, laboratories, and pharmacies implemented additional devices and remote connections into their networks. After the Office for Civil Rights (OCR) lifted penalties around telehealth to expand care options amid the crisis, new platforms were adopted that were not previously allowed […]
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