Medical Billing Myths: Medical billing is an important part of the complicated world of healthcare management. However, many practice owners struggle to negotiate the complexities of medical billing. Myths and misconceptions about medical billing can exacerbate problems, resulting in financial losses and administrative headaches. To help keep you educated and empowered, we’ve developed a list […]
Secure Medical Billing Practices: In the ever-evolving healthcare landscape, protecting patient privacy and safeguarding sensitive medical information remains paramount. The Health Insurance Portability and Accountability Act (HIPAA) serves as the cornerstone of these efforts, dictating robust data security standards for covered entities handling protected health information (PHI). As we navigate 2024, staying updated on HIPAA […]
MA rates face a potential 0.2% reduction as proposed by CMS. However, analysts said regulators are likely to increase the payout rate in the final announcement. Medicare Advantage health insurers will see a slight decline in their payment MA Rates in 2025 as a new regulatory proposal is finalized. CMS released interim reimbursement rates for […]
2024 MPFS Final Rule: If you don’t have time to read the final medical fee schedule rule, be sure to read this section. Medicare policies may have a significant impact on all payer policies. Therefore, it is important for anyone working with health insurance claims to be aware of policy changes in the New Year. […]
The Interoperability and Prior Authorization Final Rule (CMS-0057-F) aims to streamline the prior authorization process, reducing delays in patient care and lowering administrative costs. Finalized by CMS on January 17, 2024, this rule is expected to save approximately $15 billion over the next decade by reducing burdens on patients, providers, and payers. Key Impacts of […]
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 […]