Tag: medical-billing

how-ambulatory-surgery-centers-lower-payer-outpatient-spending

How Ambulatory Surgery Centers Lower Payer Outpatient Spending

Payers can reduce surgical costs by 59 percent by shifting eligible members from the hospital outpatient setting to ambulatory surgery centers. Ambulatory surgery centers are care sites that offer surgical procedures, diagnostics, and preventive care services, according to the Ambulatory Surgery Center Association. These sites are not provider offices, rural healthcare clinics, or urgent or […]
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2021-e-m-guidelines-faq-september

2021 E/M Guidelines FAQ – September

AAPC’s senior VP of products answers more of your questions about coding for office and other outpatient services. Ever since the release of the new 2021 evaluation and management (E/M) guidelines for office and other outpatient services, AAPC has been conducting numerous trainings through webinars, virtual workshops, conference sessions, online courses, and multiple articles in […]
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gain-insight-into-billing-an-e-m-with-omt

Gain Insight Into Billing an E/M With OMT

Reducing denials starts with understanding osteopathic manipulation as well as coding and coverage guidelines for this therapy. Is it appropriate to bill an evaluation and management (E/M) service when osteopathic manipulative treatment (OMT) is performed at the same visit? We must address a few key principles to adequately answer this question. I learned quickly, having […]
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take-5-medical-coding-news-august-2021

Medical Coding News – August 2021

  What are the latest code changes? Get the facts, fast. This month, there’s new billing guidance for a COVID-19 vaccine; there are three new HCPCS Level II codes for COVID-19 therapeutic injections; and Medicare payment allowances for the 2021-22 influenza vaccine codes have been released. FDA Approves COVID-19 Vaccine Pfizer’s COVID-19 vaccine received the […]
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4-patient-payments-trends-watch

Patient Payments Trends To Watch

Device agnostic digital patient intake; buy now, pay later; compassionate billing; and AI-enabled customizable payment plans are four trends that rev cycle leaders should watch as the pandemic rages on. Despite promises of a “hot-vaxxed summer,” the COVID-19 pandemic is raging on, more forcefully in some places than ever before. It’s also continuing to take […]
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cms-asks-medicare-advantage-plans-to-relax-prior-authorizations

CMS Asks Medicare Advantage Plans to Relax Prior Authorizations

  The agency emphasized relaxing prior authorizations that could impact transferrals between general acute-care hospitals and longer-term care facilities. CMS has requested that Medicare Advantage organizations relax or waive prior authorizations due to the impact of the coronavirus Delta variant. “The ability of hospitals to transfer patients to appropriate levels of care without unnecessary delays […]
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many-final-ipps-rules-are-released

Many Final IPPS Rules Are Released

While much attention has been focused on the release of the IPPS Final Rule, other final rules might have gone unnoticed. The Centers for Medicare & Medicaid Services (CMS) were very busy the first week of August, with the release of final rules for skilled nursing facilities (SNFs), hospices, inpatient rehabilitation facilities (IRFs), and inpatient […]
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cms-seeks-to-improve-healthcare-outcomes-and-drive-down-costs

CMS Seeks to Improve Healthcare Outcomes and Drive Down Costs

CMS’ proposed actions are intended to increase price transparency, access to care, patient safety, positive healthcare outcomes, and health equity. On July 19, 2021, the Centers for Medicare & Medicaid Services (CMS) announced new proposed actions to address the health equity gap, decrease mounting healthcare costs, and increase medical accessibility and patient quality of care. […]
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