Tag: Allzone Management Services

Medicare-Outpatient-Payment-Updates-for-CY-2023

Medicare Outpatient Payment Updates for CY 2023

The proposed outpatient payment updates for 2023, including the 2.7 percent reimbursement increase, do not reflect the inflationary environment in which hospitals are operating. When commenting on the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule for calendar year (CY) 2023, the American Hospital Association (AHA) supported […]
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State Surprise Billing Laws for Out of Network Payment | Case Studies | AllZone Management Services Inc.

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

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

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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No-Surprises-Act-More-to-Come

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 | Case Studies | AllZone Management Services Inc.

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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New EM Billing Guidelines for unreimbursed Services | Case Studies | AllZone Management Services Inc.

New E/M Billing Guidelines for Unreimbursed Services

Recent changes to evaluation and management (E/M) billing guidelines that allow physicians to bill for previously unreimbursed services are producing higher revenues for longer patient visits, according to results of a new study. The study in JAMA Network Open looks at the financial impact of CMS’s 2021 expansion of its time-based billing guidelines to include […]
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