Tag: Allzone Management Services

Updates to the E&M Codes and Guidelines in 2023

Updates to the E&M Codes and Guidelines in 2023

The E&M categories that will undergo revision in 2023 encompass: Inpatient and observation care services. Consultations – both outpatient and inpatient Emergency department services Nursing facility services Home and residence services Prolonged services Throughout the upcoming months, a dedicated focus will be placed on each E&M category, delving into the revisions and changes in guidelines. […]
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Automating Revenue Cycle Operations Reduces Cost-to-Collect

Automating Revenue Cycle Operations Reduces Cost-to-Collect

Health systems that used automation for revenue cycle operations had an average cost-to-collect of 3.51 percent compared to 3.74 percent for those that did not use automation. Using automation for revenue cycle operations could lower hospital and health systems’ cost-to-collect by 0.25 percent, according to a survey from the Healthcare Financial Management Association (HFMA). The […]
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State Surprise Billing Laws Impact Out-of-Network Provider Charges

State Surprise Billing Laws Impact Out-of-Network Provider Charges

Provider charges for out-of-network care increased by $1,157 after the passage of state surprise billing laws that allow arbitrators to consider provider charges in a surprise billing dispute. State surprise billing laws that allow arbitrators to consider provider charges when determining out-of-network payment amounts for surprise medical bills led to an increase in billed charges […]
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Low Reimbursement Rates Lead to Rural Hospital Closures

Low Reimbursement Rates Lead to Rural Hospital Closures

Low reimbursement rates, staffing shortages, low patient volumes, and regulatory barriers are some of the root causes of rural hospital closures, the American Hospital Association (AHA) explains in a new report. The report “Rural Hospital Closures Threaten Access: Solutions to Preserve Care in Local Communities” highlights the variety of causes behind rural hospital closures, which […]
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2023 Medicare Physician Fee Schedule on Unsustainable Cuts

2023 Medicare Physician Fee Schedule on Unsustainable Cuts

Lower Medicare payments to physicians will lead to patient care by reducing access to services, according to medical groups commenting on the 2023 Medicare Physician Fee Schedule (PFS). In July, the U.S. Centers for Medicare & Medicaid Services (CMS) announced the 2023 proposed rule and physician groups have been responding, including with detailed comments published […]
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Physician Practice Costs Grew 20% Per Claim

Physician Practice Costs Grew 20% Per Claim

Following a private equity acquisition, physician practices saw a 20.2 percent increase in charges per claim, an 11 percent raise in the allowed amount per claim, and a 37.9 percent increase in new patient visits. Private equity acquisition of physician practices in dermatology, gastroenterology, and ophthalmology was associated with increased healthcare spending and utilization, according […]
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More Versions to Come: No Surprises Act

More Versions to Come: No Surprises Act

Although the Biden Administration claims this is the final regulation, there is evidence more is yet to come. The Biden administration released the final No Surprises Act regulation recently but advised healthcare professionals that this final version is not the final one and promised more to come. The latest final rule was narrowly focused on […]
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Prior Authorization Reform in Medicare Advantage

Prior Authorization Reform in Medicare Advantage

Prior Authorization reform in Medicare Advantage would help relieve administrative burden for medical groups and reduce patient care delays, MGMA said. The Medical Group Management Association (MGMA) has urged CMS to implement policies that support prior authorization reform and value-based care contracts within the Medicare Advantage program. MGMA submitted comments to CMS Administrator in response […]
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