Tag: Healthcare Reimbursement

Survey: High Initial Claim Denials Impact Healthcare Providers

The Rising Denial Rates in Healthcare Claims Processing Initial Claim Denials: In a new survey conducted by healthcare Company an increased percentage of initial claims are denied by private payers, including pre-approvals for medical claims. Hospitals, health systems, and post-acute care providers may have a difficult time getting paid for medical services. The survey respondents […]
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Preventive-Visits-VS-Office-Visits

Differences: Preventive vs. Office Visits in Medical Coding & Billing

Preventive Services Vs Office Visits: It is important to note that Medicare does not cover preventive services in the same manner as commercial payers. Therefore, it is important to know the patient’s policy and insurance coverage. Table A shows a breakdown of the coverage parameters. Understanding the distinction between Preventive Services Vs Office Visits is […]
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NSA Implementation

Congressional Concerns: Lawmakers Challenge CMS on NSA Implementation

NSA Implementation Shortly before Congress adjourns for 2023; lawmakers sent another in a series of letters to the Centers for Medicare and Medicaid Services (CMS) expressing “serious concerns” about the implementation of the No Surprises Act (NSA). The letter accused CMS of failing to properly implement key portions of the law and suggested that the […]
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Physicians-face-dual-burden-between-patient-care-and-medical-coding

Clinicians Struggle with Medical Coding Amid Patient Care Responsibilities

Presently, healthcare professionals face growing administrative demands alongside their patient-focused duties. A pivotal challenge among these is medical coding, essential for various reasons. It ensures adherence to billing standards impacting reimbursements, meets quality metrics established by healthcare entities and insurers, and guarantees precision in diagnoses recorded for billing purposes. Yet, the task of accurate coding […]
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2024-Medicare-Telehealth-reimbursement-waiver

Medicare’s Telehealth Reimbursement Waiver Extended to 2024

The final 2024 Medicare Physician Fee Schedule includes a provision that allows health systems to bill Medicare for telehealth services provided by doctors from their homes. This extension of a crucial Medicare reimbursement for health systems using telehealth services lasts until the end of 2024, and it also grants physicians working from home added privacy […]
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CMS-Medical-Billing-Changes

Unnoticed Medical Billing Changes in 2023

While not every policy alteration by the Centers for Medicare & Medicaid Services (CMS) grabs headlines, it’s often these less-publicized changes that lead to the most billing complications. Here are a couple of recent adjustments made by CMS that you might have overlooked. New Place of Service Code CMS introduced a new Place of Service […]
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Accurate-Medical-Coding-in-Healthcare-Reimbursement

The Profound Importance Of Medical Coding Services in Healthcare Reimbursement

In the intricate realm of healthcare, where patient well-being is paramount, the financial dimension often receives less attention. Yet, it’s imperative to recognize that healthcare encompasses not only patient treatment but also ensuring fair compensation for healthcare providers. Precise medical coding is a cornerstone of this endeavor. This piece delves into the profound importance of […]
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CMS-announced-433--ICD-10-Codes-Changes-For-2024

CMS announced 433  ICD-10 Codes Changes For 2024

The fiscal year 2024 ICD-10-CM codes have recently become active, and they will have an impact on your reimbursement. Earlier this year, CMS announced the incorporation of 395 fresh diagnosis codes, removal of 25 codes from the diagnosis set, and modification of 13 codes— all of which became effective on October 1. A substantial portion […]
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AMA-unveils-2024-CPT-codes

AMA Unveils 2024 CPT Codes

The revised code set now features descriptions of procedures and services in Spanish for the first time. The American Medical Association’s 2024 Current Procedural Terminology (CPT) code set, revealed today, encompasses various noteworthy features. These include consolidated codes for reporting ongoing COVID-19 immunizations, provisional codes for upcoming monovalent vaccines, and codes for Respiratory Syncytial Virus […]
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Healthcare Revenue Cycle Management
  • September 8, 2023

How Revenue Cycle Management Improves Healthcare in 2023

Discover how healthcare providers can accelerate cash flow, minimize denials, reduce operational costs, and enhance patient satisfaction through streamlined Revenue Cycle Management (RCM). RCM is a strategic approach to overseeing all financial aspects of a patient’s journey, from initial appointment scheduling to final bill payment. This article highlights the critical role RCM plays in maximizing […]
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