Category: Revenue Cycle Management

Medicare Beneficiaries for COVID Antibody Treatment

CMS Approves Coverage of COVID Antibody Treatment for Medicare Beneficiaries

New COVID cases reported daily have more than doubled during recent weeks, since a more modest July surge. As the nation’s COVID-19 pandemic continues to spiral out of control, federal authorities are racing to find ways to mitigate the spread. The Centers for Medicare & Medicaid Services (CMS) announced last week that Medicare beneficiaries will […]
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Telehealth Advancements

American Medical Association Passes Pro-Telehealth Resolution

American Medical Association delegates adopted a policy this week directing the organization to keep working to support telehealth advancements during and after the COVID-19 pandemic. The American Medical Association this week resolved to continue advocating for telehealth after the COVID-19 pandemic, particularly among underserved communities. After physicians and medical students gathered virtually for five days, […]
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Automation in Prior Authorization

Industry Voices – Advancing Automation for Prior Authorization

If there’s one thing healthcare providers can agree on, it’s that prior authorization management is a heavy administrative burden and only growing heavier. Decades ago, it was created to ensure care standards continuity, improve safety and regulate costs but has become an unwieldy process filled with manual tasks and roadblocks that dilute the original intent. […]
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Benefits of AI Analytics

Top 5 Business Benefits of Early AI-Analytics Adopters

  Pre-trained AI for life sciences opens endless possibilities where the application readily understands life sciences data sources, business terminologies, and key metrics. Out-of-the-box models allow for a seamless integration with enterprise applications and are easily deployed within weeks, and don’t demand any major investments in change management from the business or IT. Models that […]
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Denials Management Plan

6 Action Items for Your Denials Management Plan

There’s so much noise around denials management that it can be hard for even the most seasoned revenue cycle executives to cut through the clutter, find clear solutions, and make a solid plan. But that’s exactly what Kimberly Scaccia, vice president of revenue cycle at Mercyhealth in Wisconsin and Illinois, helped listeners do last month during a HealthLeaders webinar sponsored by Change […]
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Payment for New COVID-19 Treatments

CMS Finalizes Additional Payment for New COVID-19 Treatments

CMS’ Fourth COVID-19 Interim Final Rule with Comment Period (IFC-4) includes additional payment for new COVID-19 treatments, price transparency requirements for COVID-19 diagnostic tests, and coverage for potential vaccines among other provisions. Most provisions of IFC-4 became effective November 2. Hospital Payment for New COVID-19 Treatments The New COVID-19 Treatments Add-on Payment (NCTAP) will provide additional Medicare […]
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Medicare Reimbursement for Home Dialysis

CMS Expands Medicare Reimbursement for Home Dialysis, ESRD

New and innovative home dialysis machines will soon qualify for additional Medicare reimbursement, according to the latest End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) final rule. CMS released the final rule yesterday, which introduced the new transitional add-on payment for dialysis machines used in patient homes and also included an update to Medicare reimbursement rates […]
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COVID-19 Vaccines

Coronavirus: CMS Releases Plan For Vaccine Patient Price, Reimbursement

  The Centers for Medicare and Medicaid Services (CMS) is laying the groundwork for the widespread release of a COVID-19 coronavirus vaccine by releasing an interim final rule with comment period (IFC) with information on out-of-pocket patient costs and physician reimbursements. According to a news release, any vaccine which is authorized by the U.S. Food and […]
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