Surprise billing compliance will have impacts throughout the revenue cycle, so preparation now is key to meeting the January 1st deadline. A prohibition on surprise billing is coming at the start of next year and federal agencies have started to release what surprise billing compliance will look like. These new compliance requirements will have a […]
New legislation aims to eliminate the cost-sharing requirement for Medicare beneficiaries to get chronic care management services and reimburse providers for 100% of the payment. The legislation, reintroduced Thursday, intends to boost access among seniors to chronic care management services that include creating a care plan and medication reconciliation and adherence. “Chronic health conditions […]
Outside financial aid might not be the best long-term solution to the national problem of high healthcare costs and inadequate insurance coverage, but two rural hospitals are taking innovative approaches to tapping philanthropic resources to reduce their bad debt and help patients with medical bills. The American Hospital Association’s latest Annual Survey of Hospitals showed […]
Understanding the qualifying payment amount and the initial information on the independent dispute resolution process “should be a short-term priority for revenue cycle leaders and their teams,” says attorney Harvey Rochman. Earlier this month, the federal government released an interim final rule outlining certain provisions of the No Surprises Act (NSA), which is designed […]
The interim rule is in response to the No Surprises Act, which directed multiple US departments to issue a rule that would quell surprise billing in commercial health plans. The Biden administration has issued an interim rule that regulates surprise billing in commercial health plans and employer-sponsored health plans, CMS announced. “No patient should forgo […]
The final rule is an implementation of the No Surprises Act, which was passed by Congress last year. The U.S. Department of Health and Human Services issued an interim final rule this week banning surprise medical bills and some out-of-network charges, which will go into effect on January 1, 2022 for providers and insurance […]
Physicians enter into health care because they want to help care for patients, not to become business people. This can make revenue cycle management (RCM) seem like an overwhelming or complex set of steps, yet, at its essence, “it is basically about obtaining payment for services rendered to a patient,” says Kelly Dingwell, principal attorney […]
Our hospital has been denied CPT code 52601 because the operative report does not mention the word complete. Although the operative note described the procedure in detail and the pathology report showed benign prostatic hyperplasia (BPH) tissue, why do we need to state the word complete? What does it mean in the CPT description? CPT […]
In anticipation of an emergency use authorization from the Food and Drug Administration (FDA), the American Medical Association (AMA) has created Current Procedural Terminology (CPT) codes for AstraZeneca’s COVID-19 vaccine. AMA assigned Category 1 CPT code 91302 to the vaccine manufactured by the Cambridge, United Kingdom (UK) company, as well as vaccine administration CPT codes […]
A version of this article was first published December 14, 2020, by HCPro’s Revenue Cycle Advisor, a sibling publication to HealthLeaders. CMS recently released two new HCPCS Level II codes for Regeneron’s antibody drugs casirivimab and imdevimab, effective for dates of service on or after November 21. The creation of the new codes comes […]