Tag: Healthcare Payments

medical-organizations-continue-to-fight-surprise-billing-dispute-process-5-details

Medical organizations continue to fight surprise-billing dispute process: 5 details

A coalition of medical organizations, including the Physicians Advocacy Institute and 16 state medical associations, filed an amicus brief supporting a legal challenge to the No Surprises Act dispute resolution process, according to a news release emailed to Becker’s. Five things to know: The groups are supporting a lawsuit filed by the American Hospital Association […]
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hhs-distributing-9-billion-covid-19-relief-funds-providers-week

HHS distributing $9 billion in COVID-19 relief funds to providers this week

Average payments are $58,000 for small providers, $289,000 for medium providers, and $1.7 million for larger providers. The U.S. Department of Health and Human Services, through the Health Resources and Services Administration (HRSA), said it’s distributing about $9 billion in Provider Relief Fund payments to providers, with a particular focus on smaller providers. This is […]
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steps-you-can-take-to-defend-against-exclusion-of-zero-paid-claims

The Steps You Can Take to Defend Against Exclusion of Zero-Paid Claims

Zero-paid claims are defined as any claims submitted by healthcare providers that are not paid. The problem is that when performing statistical extrapolations, auditors (ZPICs, or Zone Program Integrity Contractors, and others) routinely screen out zero-paid items when they extract the claims from a sample. This is a violation of at least 12 parts of […]
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health-systems-set-sights-on-risk-based-payment-in-medicare-advantage

Health Systems Set Sights on Risk-Based Payment in Medicare Advantage

Over half of health systems also said they plan to advance risk-based payments or some form of capitation in commercial lines of business. The executive survey conducted by the Healthcare Financial Management Association (HFMA) for the Guidehouse Center for Health Insights found that nearly 60 precent of health systems are looking to advance into risk-based […]
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improper-medicare-payments-down-20b-since-2014-cms-data-shows

Improper Medicare payments down $20.7B since 2014, CMS data show

  The number of improper payments made under Medicare fee-for-service declined by $20.72 billion since 2014, according to new figures from the Biden administration. “The continued reduction in Medicare fee-for-service improper payments represents considerable progress toward the Biden-Harris Administration’s goal of protecting CMS programs’ sustainability for future generations. We intend to build on this success […]
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cms-releases-final-rule-for-cy-2022-medicare-physician-fee-schedule

CMS Releases Final Rule for CY 2022 Medicare Physician Fee Schedule

CMS has finalized the calendar year (CY) 2022 Medicare Physician Fee Schedule to promote greater telehealth utilization, boost reimbursement rates for vaccine administration, and improve health equity, among other initiatives, the federal agency said. The final rule will implement “a series of standard technical proposals” as part of CY 2022 rate-setting, CMS said. The conversion […]
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