Tag: Reimbursement Rates

5 Ways to Reduce Claims Denial in Your Revenue Cycle

Reduce Claims Denial in Your Revenue Cycle

Claims Denial: Healthcare Leaders report an increase in payer denials, putting increasing pressure on the system’s finances. Going back and forth with denied payers is a long and expensive process, and low reimbursement rates don’t help either. In a new survey conducted by the Healthcare Financial Management Association, CFOs noted a significant increase in denials, […]
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Billing Codes

Telehealth vs In-Person Visits: How Often Virtual Service Billed at Lower Code

According to research, telehealth visits, both in primary and specialty care, tend to be coded more frequently with lower level-of-service billing codes. Despite the option to receive higher facility rates for telehealth services for another year, providers often bill these virtual visits using lower level-of-service codes. This pattern holds true for both primary and specialty […]
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Medicare rate for COVID-19 vaccinations

MA Reimburses 2X Medicare Rate for Some COVID-19 Vaccinations

Healthcare providers in Massachusetts are getting twice the standard Medicare rate for COVID-19 vaccinations in an effort to accelerate vaccine rollout, according to a recent provider bulletin from the state’s Medicaid office. The provider bulletin released in January 2020 states that providers administering the two-dose vaccines from Pfizer and Cambridge, Massachusetts-based Moderna will receive $33.88 for the […]
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Surprise Billing Solution

Providers, Insurers Parse What They Could Support – And What They Won’t – In Surprise Billing Solution

While both providers and insurers have found it difficult to agree on a solution to surprise billing, experts on both sides expressed support Tuesday for banning the practice – thereby forcing insurers and providers to work out payment disputes among themselves—when patients have gone to in-network hospitals. The approach, which has been tried in Oregon, […]
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Insurers, Providers Spar Over Solution to Surprise Medical Bills

America’s Health Insurance Plans called on Congress to set a fixed reimbursement rate based on what insurers pay in a region. Providers are pushing back against an insurer proposal for legislation to set reimbursement rates to avoid surprise medical bills. In a letter to Senate and House leaders this week, America’s Health Insurance Plans and 16 other […]
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Four Ways RCM Must Transform for the Shift to Value-Based RCM

Value-based care is driving transformation of many established operations within medical groups—and the revenue cycle is no different. It is likely that 2018 will be remembered as the year that value-based care became a financial reality for most U.S. medical practices. Those participating in MIPS (the Merit-based Incentive Payment System) received their first round of […]
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