Emergency medicine is facing a host of claims reimbursement updates this year, from looming Medicare payment cuts to new rules about the split and critical care visits. Emergency department providers are still reeling from the effects of the ongoing pandemic. But other important updates are also happening in the background—and they are likely to impact […]
Payers, providers, and members can all benefit from transforming the manual and patchwork claims payment process to a digital environment that also automates claims data delivery. Payers, providers, and members are all central to the healthcare experience, working together to create a seamless, coordinated encounter from registration and the clinical visit to claims payment and […]
. The End-Stage Renal Disease (ESRD) Treatment Choices Model is the first to undergo changes to directly address health equity—a new goal for CMS-run alternative payment models. The ESRD Treatment Choices (ETC) Model is a mandatory alternative payment model (APM) that encourages greater utilization of home dialysis and kidney transplants for Medicare beneficiaries with the […]
About 41% of primary care clinicians say going back to pre-pandemic telehealth reimbursement rules would kill virtual care at their practices and exacerbate staffing issues. The survey conducted in mid-August by the Larry A. Green Center, in collaboration with the Primary Care Collaborative (PCC), found that primary care practices have come to rely on telehealth. […]
HHS reduced the Medicare appeals backlog by 79 percent during the third quarter of FY 2021, putting the department ahead of schedule to clear the backlog. As of June 30, 2021, the end of the third quarter of FY 2021, HHS had 86,063 pending appeals remaining at the Office of Medicare Hearing and Appeals (OMHA), […]
In its simplest form, revenue cycle management is the process healthcare providers use to ask for, track, and collect revenue for services rendered to patients. But as medical billing gets more complex, revenue cycle management is expanding beyond the business office. At Jackson Hospital in Montgomery, Alabama, for example, revenue cycle management also includes health […]
Healthcare B2B payment transactions have been high in 2021, potentially signaling the importance of electronic payment transfers as the nation emerges from the coronavirus pandemic, according to a report from National Automated Clearing House Association (NACHA). Nacha oversees the ACH Network, a national payment system. B2B payments made through this network in the healthcare industry […]
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 […]
The industry group urged lawmakers to stop proposed cuts to Medicare payment for physicians as outlined in recent legislation and regulation. Medical groups are urging Congress to prevent significant cuts to Medicare payment that could be triggered by recent spending bills and a proposed rule from CMS. In a letter to Congressional leaders, AMGA (American […]
Medicare will pay an additional reimbursement of about $35 per dose administered for up to a maximum of five vaccine administration services per home unit or communal living space, as long as it is in a single group living location, CMS posted on its website earlier today. The payment boost means that Medicare will reimburse […]