Outsourcing Billing: Hospital and medical professionals acknowledge that the biggest issue they have are receiving payment for their services. Those in the medical field understand all too well the issue of delayed revenue and dormant collections. Though technology has improved the in-office process, the inadequate handling of the hugely important Medical billing process can lead […]
Collecting patients is not an easy job, but there are ways to handle it in an efficient and compassionate manner. We talk to experts on how to prevent payment delinquencies and how to handle them when they occur. Ways to prevent delinquencies Before physicians worry about collecting delinquent payments, there are several strategies to ensure […]
Due to technological innovation, the healthcare sector faces greater transformation. Adopting new technologies and implementing virtual care brought significant change in Medical Billing. The year 2022 ends with a substantial rise in the adoption of payment systems and the implementation of new technologies in the Medical billing process. In addition, the integration of advanced Medical […]
The AHA and American Medical Association yesterday filed a friend-of-the-court brief in support of a Texas Medical Association lawsuit claiming the revised independent dispute resolution process for determining payment for out-of-network services under the No Surprises Act skews the arbitration results in commercial insurers’ favor in ways that violate the compromise Congress reached in the […]
CMS has published the Fiscal Year 2023 (Oct 1, 2022) final rules for Medicare payments. The major rule is, of course, the inpatient hospital prospective payment system (IPPS) and long-term care hospital (LTCH) PPS rule. The final rule, as reported by Stanley Nachimson, contains several payment and quality program changes that go into effect Oct […]
Appeal rights appear much narrower than many expected. Earlier this year, a federal appeals court issued an opinion on Barrows v. Becerra, a long-running class action lawsuit. Filed by a group of Medicare beneficiaries, the suit alleged they had to pay out of pocket for skilled nursing care—despite being hospitalized for over three days—because their […]
Three tips are all you need to correctly bill allergen immunotherapy, single or multiple antigens. Allergy services, such as those reported with CPT® 95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single or multiple antigens (specify number of doses), remain on the radar of third-party payer investigation units […]
Despite myths to the contrary, physicians are not prohibited from coding and billing for both preventive and problem-focused evaluation and management (E/M) services when they are performed during the same appointment. Motivated by a desire to avoid audits, many physicians tend to undercode for the work they perform. Others, however, are just unaware that the idea that […]
CMS issued a proposed rule to update payment rates and policies under the End-Stage Renal Disease Prospective Payment System for renal dialysis services furnished to Medicare beneficiaries on or after Jan. 1, 2023. Here are four takeaways from the proposed rule: Under the proposed rule, Medicare expects to pay $8.2 billion to approximately 7,800 facilities […]
Observation, outpatient outlier payments, and the Inpatient-only List: Getting it right is not always easy. On this week’s Monitor Mondays we had a robust discussion about Condition Code 44. And on June 9, I will be presenting a webinar on the nebulous concept of “outpatient” service in a bed. Both of these have one thing […]