medical-billing Archives - Page 3 of 15

August 18, 2022
Blog, Medical Billing
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High Out-of-Pocket Costs Led to Low Patient Collection Rates

Self-pay after insurance patient collection rates dropped from 76 percent in 2020 to 55 percent in 2021 as the share of out-of-pocket balances over $7,500 grew. Patient collection rates at hospitals declined and bad debt increased when out-of-pocket bills reached $7,500, according to a report from Crowe Revenue Cycle Analytics (Crowe RCA). The report reflects […]

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Coding Drives Up Medical Billing Costs in the US

August 8, 2022
Blog, Medical Billing
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Coding Drives Up Medical Billing Costs in US

Another study confirms that medical billing costs in the US significantly exceed those in similar countries, but researchers now know why: coding drives up US administrative spending. Complex coding structures in the US are driving up medical billing costs in the US, making it one of the most expensive countries to get paid, according to […]

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AMA Announces CPT Code for Moderna COVID-19 Vaccine for Young Kids

While the Moderna COVID-19 vaccine for young children has yet to receive FDA authorization, AMA has created a CPT code to ensure healthcare professionals are prepared for the shot’s potential use. The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include CPT codes for the Moderna COVID-19 vaccine for […]

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April 19, 2022
Blog, Medical Coding
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Measuring Revenue Cycle Health Through Denials Management

An organization’s denial rate is a good barometer of its overall financial health and the soundness of its revenue cycle. A recent survey details how organizations stack up. Although most organizations do a good job of tracking denials by reason, payer, and volume, they miss the mark when communicating information about appeals, appeal success […]

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November 16, 2021
Blog, Medical Billing
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Claims Payment Transformation Benefits Payer, Providers, and Members

Payers, providers, and members can all benefit from transforming the manual and patchwork claims payment process to a digital environment that also automates claims data delivery. Payers, providers, and members are all central to the healthcare experience, working together to create a seamless, coordinated encounter from registration and the clinical visit to claims payment and […]

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November 13, 2021
Blog, Medical Billing
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CMS Releases 2022 Physician Fee Schedule Final Rule

The Centers for Medicare & Medicaid Services (CMS) has finalized 2022 payments and policies under the Medicare Physician Fee Schedule (MPFS). The rule includes updates to payment rates for physicians and other healthcare professionals for calendar year (CY) 2022; expands the use of telehealth for mental health; clarifies policies related to split (shared) visits, critical […]

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November 11, 2021
Medical Billing
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Lawmakers Seek Changes to No Surprises Act Implementation

More than a third of Representatives call on the federal government to revise No Surprises Act implementation, specifically around the independent dispute resolution process. A bipartisan group of 152 House members wrote to the secretaries of Health and Human Services, Treasury and Labor and urged them to amend the interim final rule (IFR) that will […]

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how-billing-turns-routine-birth-high-cost-emergency

November 1, 2021
Blog, Medical Billing
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How Billing Turns A Routine Birth Into A High-cost Emergency

Caitlin Wells Salerno knew that some mammals — like the golden-mantled ground squirrels she studies in the Rocky Mountains — invest an insane amount of resources in their young. That didn’t prepare her for the resources the conservation biologist would owe after the birth of her second son. Wells Salerno went into labor on the […]

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High Healthcare Spending Shifts to Uninsured, Prescription Drugs

In nearly two decades, the overall concentration of healthcare spending has remained steady, but there has been an increase in the concentration of prescription drug spending, according to a study in JAMA Network Open. To find the concentration curves of cumulative percentage of healthcare spending versus percentage of ranked population, researchers analyzed data sets from […]

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September 9, 2021
Blog, Medical Coding
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AMA Updates CPT Codes for COVID-19 Vaccines

The updates include unique CPT codes for a new formulation of the COVID-19 vaccine developed by Pfizer and new codes for booster doses expected to roll out later this month. The American Medical Association (AMA) has announced updates to the Current Procedural Terminology (CPT) code set to account for changes to COVID-19 vaccines, including booster […]

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Tag: medical-billing

High Out-of-Pocket Costs Led to Low Patient Collection Rates

AMA Announces CPT Code for Moderna COVID-19 Vaccine for Young Kids

Measuring Revenue Cycle Health Through Denials Management

Claims Payment Transformation Benefits Payer, Providers, and Members

CMS Releases 2022 Physician Fee Schedule Final Rule

Lawmakers Seek Changes to No Surprises Act Implementation

How Billing Turns A Routine Birth Into A High-cost Emergency

High Healthcare Spending Shifts to Uninsured, Prescription Drugs

AMA Updates CPT Codes for COVID-19 Vaccines

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