An improved Prior Authorization Final Rule can result in shorter wait times, fewer delays in the delivery of patient care, and a reduction in costs. CMS has finalized the Interoperability and Prior Authorization Final Rule (CMS-0057-F), which was published by CMS on January 17, 2024. It will reduce the burden on patients, providers, and payers […]
Medical coding challenges: Medical coding in healthcare is the process of converting complicated medical information into standardized codes that may be used for Medical billing and record keeping. Medical coding presents unique obstacles, even though it is critical for guaranteeing proper compensation and keeping a complete patient history. In this article, we’ll navigate through common […]
The federal No Surprises Act (NSA) has generated millions of complaints but serves to protect consumers from unexpected out-of-pocket healthcare costs, according to a new survey. AHIP, a U.S. health insurance trade group, and the Blue Cross Blue Shield Association (BCBSA) released a report that estimates the NSA prevents more than 1 million surprise bills […]
The CY 24 MPFS final rule last run the show was disseminated inside the November 16, 2023 Government Select. The run they appear addresses updated installment for specialist and other specialist administrations conjointly sets out unused rulemaking concerning certain other providers and things, such as ambulances, inquiries about offices and other demonstrative offices, and pharmaceutical […]
In an effort to streamline prior authorization processes, provider bunches, including the American Medical Association (AMA) and the Medical Group Management Association (MGMA), have asserted that the ultimate goal of the new regulations will assist in facilitating a more efficient and effective prior authorization workflow. Provider bunches are commending CMS for finalizing understanding data-sharing approaches […]
As a result of the most recent provider lawsuit, IDR processing fees have been reworked. Since its inception on Jan. 1, 2022, the No Surprises Act (NSA) has had its growing pains, including four lawsuits challenging the process of Independent Dispute Resolution (IDR). Out-of-network services are paid for with this process when health plans, healthcare […]
The Healthcare industry 2022 survey found that most hospitals fail to meet new billing measures. There is a shortage of qualified billing representatives at most hospitals, and patient itemized bills are not issued on time. Based on the Healthcare Industry survey’s new measures added in 2022, a study published in Healthcare media examined the quality […]
As a result of their hospital stays that exceeded three days – all of which were outpatient Part B stays – a group of Medicare beneficiaries filed a class action lawsuit in 2010 to recover their costs from stays in skilled nursing facilities (SNFs) for rehabilitation following an illness. It was probably the height of […]
To capture Medicare reimbursement for complex Medicare patient visits, you must know when to use this G2211 Code add-on code. To report the additional time, effort, and related practice expenses associated with caring for Medicare patients across the continuum of care, qualified healthcare providers can begin billing HCPCS Level II codes on Jan. 1, 2024. […]
In addition to being a blessing to humanity, healthcare is frequently a maze of perplexing invoices and obscure codes. But don’t worry, tired traveler! With a few clever modifications, this terrible beast can be transformed into a controllable monster burrow. Prepare your clever sword and defeat the 5 Hacks for Healthcare Billing dragons listed below: […]