The increasing demand for incontinence products is prompting home medical equipment (HME) providers to reevaluate their existing incontinence programs. With the U.S. witnessing a significant rise in the aging population, marked by 10,000 people turning 65 every day according to the U.N. Population Division, there is a growing market for incontinence products. Studies from Mayo […]
The impact of prolonged turnaround times from billers in medical billing is frequently underestimated, yet it has far-reaching consequences for everyone involved. Delays in processing times impose financial burdens on healthcare organizations and patients. By gaining insight into the concealed costs and inefficiencies, we can enhance the process and achieve more favorable financial outcomes. In […]
Claims management serves as a valuable tool for insurance firms, enabling them to identify the root causes of claim errors, measure areas for improvement, and explore new opportunities to continuously enhance their operations. However, the ever-increasing complexity of claims administration poses a formidable challenge for insurance businesses, hindering their ability to uncover fresh prospects and […]
A new final rule from the Centers for Medicare and Medicaid Services (CMS) will make it harder for Medicare Advantage (MA) plans to require prior authorizations for their coverage The rule comes in the wake of a 2022 report from the Office of Inspector General of the US Department of Health and Human Services that […]
The agency proposes to strengthen the ties that bind payments to quality data reporting. The Centers for Medicare & Medicaid Services (CMS) issued, April 10, the Inpatient Prospective Payment System/Long-Term Care Hospital (IPPS/LTCH) proposed rule for fiscal year (FY) 2024. If finalized as written, inpatient hospitals and LTCHs that do not successfully report quality data […]
Two letters. They’re enough to give your patients more anxiety than any treatment, test or injection. A recent survey by the Pew Research Center shows it: Sixty percent of Americans said they would be uncomfortable with their provider relying on artificial intelligence (AI) in their own health care. But when used responsibly, artificial intelligence can […]
You won’t find these codes in your 2023 code books, but they are effective April 1. The Centers for Medicare & Medicaid Services (CMS) has released coding changes and policy updates for the Outpatient Prospective Payment System (OPPS). The updates include the addition of many new HCPCS Level II codes, the deletion of a few […]
In recent years, there has been an increase in scrutiny regarding the use of modifier -25 to identify separate evaluation and management (E/M) services on the same day as another procedure. Insurers are now demanding documentation of such services both before and after payment, leading to a significant administrative burden for urology practices. The reason […]
CPT code 99214. Is that Jean Valjean’s number? No. It is an evaluation and management (E&M) code of moderate complexity. Few CPT® codes cause goosebumps, a chill in the air, and a pit in your stomach besides CPT code 99214. It is an E&M code of moderate complexity. For a low-complexity visit, the code decreases […]
Three big CMS moves have affected physician reimbursements in the last 10 years, according to VMG Health’s 2023 mergers and acquisitions report released on March 21: Here are the three CMS policies: In April 2015, the Senate passed the Medicare Access and CHIP Reauthorization Act, which permanently removed the sustainable growth rate formula under the […]