Tag: medicare payment

Medicare MIPS

MIPS Proving a Financial Boon for System-Affiliated Doctors

Doctors looking to earn more under Medicare’s Merit-based Incentive Payment System (MIPS) would likely benefit from working in a practice affiliated with a hospital system. A recently-published study in JAMA finds that doctors in system-affiliated practices earned substantially higher MIPS scores in 2019 than those in independent practice, and were thus more likely to receive upward payment adjustments and […]
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Medicare Advantage Plans

Medicare Advantage Plans Could See Payments Drop in 2021 Due To Covid-19, Analysis Finds

  The COVID-19 outbreak appears to have impacted claims patterns for Medicare Advantage enrollees, according to a new analysis by Avalere Health. Even though seniors are historically the most vulnerable population health-wise, their claims were down dramatically during the month of April. The survey suggests it could impact risk score factors for MA plans in 2021, driving […]
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Telemedicine Coding

Telemedicine Takes Healthcare Into the 21st Century

  Update your understanding of how to code telehealth services now and in the future. Without telehealth, the COVID-19 pandemic could be much worse. Imagine if practitioners were not able to socially distance their infected patients from their healthy patients. Think of all the people who would not seek medical attention if it meant leaving […]
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High-Throughput COVID-19 Testing Codes

Coding High-Throughput COVID-19 Testing

The Centers for Medicare & Medicaid Services (CMS) created two new HCPCS Level II codes for lab tests that use high-throughput technologies to detect SARS-CoV-2, the virus that causes COVID-19. The rate for these codes is $100, roughly twice the rate of similar tests that don’t use high-throughput technologies. Consider New Codes in Place of […]
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AR Management

How To Manage Accounts Receivable

Sound accounts receivable (A/R) management is integral to the financial health of a medical practice. The ability to maximize collections and profitability depends on it. Thus, it’s important that practices know what processes they can implement to ensure a smooth-running AR operation. David Norris, MD, MBA, an anesthesiologist in Wichita, Kan. and author of The […]
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Physician Assistant Bill

When is a PA an Assistant Surgeon?

A physician assistant (PA) serves as an assistant surgeon only to suture and close an incision. There is no documentation that the PA performed any other function to assist the primary surgeon during the surgery performed on the Medicare patient, such as providing extra hands needed for tasks which required more than the surgeon’s two […]
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Medicare Advantage Overpayments

CMS Goes After Medicare Advantage Overpayments

The Centers for Medicare & Medicaid Services (CMS) knows that a significant amount of money is being overpaid to insurance companies in the Medicare Advantage program, but they have yet to recover these overpayments. That’s about to change. CMS says it will increase the audits being performed on Medicare Advantage risk-adjusted code submissions and apply […]
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