Tag: American Medical Association

Prior Authorization Requirements

Physician Discovers Hidden prior authorization Details in CPT Codes

A proposal to track prior authorization using CPT codes was pulled back for revision after a surprising finding. An urologist, advocated for the plan to compensate physicians for time spent on prior authorization requirements. He also hoped it would streamline the process and improve patient care. However, the American Medical Association (AMA) informed urologist that […]
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Prior Authorization Reform Rule Proposals

CMS Unveils Contentious Prior Authorization Reform Rule Proposals

Physicians and healthcare experts are urging Medicare to lead reforms in the time-consuming prior authorization (PA) process, which often causes delays in patient care. However, they caution against excessive reform, as it could exacerbate the problem rather than improving it. The U.S. Centers for Medicare and Medicaid Services (CMS) have put forth two proposals for […]
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Evolving E&M Documentation: Where We’ve Been and Where We’re Headed

Providers today are stuck using outdated templates, leaving ample room for improvement. Let’s take a retrospective look at evaluation and management (E&M) services—examining what we had, what we have now, and what lies ahead. Before the implementation of the 2021 documentation guideline (DG) changes, many providers relied on templates built around outdated office-based documentation requirements […]
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AMA: Prior Authorization Creates Physician Burden, Patient Care Delays

Although health plans aim to promote value-based care with prior authorization requirements, providers and patients may experience negative repercussions from the process. Prior authorization negatively impacted patients and providers alike by leading to care delays for patients and creating administrative burden for physicians, according to a survey from the American Medical Association (AMA). Health plans […]
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Health Insurance Industry Consolidation Grew from 2014 to 2020

  Health insurance industry consolidation continued to increase, restricting consumers’ options for coverage, an American Medical Association report argued. “As merger rumors involving health insurers swirl, the prospect of future consolidation in the health insurance industry should be more closely scrutinized given the low levels of competition in most health insurance markets,” Gerald E. Harmon, […]
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AMA Updates CPT Codes for COVID-19 Vaccines

The updates include unique CPT codes for a new formulation of the COVID-19 vaccine developed by Pfizer and new codes for booster doses expected to roll out later this month. The American Medical Association (AMA) has announced updates to the Current Procedural Terminology (CPT) code set to account for changes to COVID-19 vaccines, including booster […]
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