Several lawmakers are seeking to tie physician payment updates in Medicare to inflation to prevent potential physician shortage issues. Representatives Raul Ruiz, MD (D-CA-25), Larry Bucshon, MD (R-IN-08), Ami Bera,…
Outpatient visits are being billed at higher levels, leading to increased healthcare spending and concerns about upcoding, a Peterson-KFF Health System Tracker found. Healthcare providers can bill outpatient evaluation and…
Following the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare claims for telestroke services increased in rural and urban emergency departments. However, there was still substantial underbilling from hospitals with…
CMS has officially rescinded a final rule published by the Trump Administration that would have expedited the Medicare coverage process for breakthrough devices. The agency said it will take a…
Skilled nursing facility (SNF) staffing levels across several provider types have fallen since Medicare implemented new payment rules meant to drive value over volume of services, according to a new…
Funding legislation aimed at keeping HHS and other non-Defense agencies running in fiscal year (FY) 2020 will also postpone $4 billion in Medicaid Disproportionate Share Hospital (DSH) payment cuts until…
According to a Healthcare & Business Technology report regarding medical billing, almost $125 billion in uncollected revenue happens each year due to: 1. medical billing errors, and 2. failure to…
Thirty-eight hospitals filed a lawsuit against HHS over a $380 million reduction in Medicare reimbursement to hospitals under a new outpatient site-neutral payment policy. The lawsuit alleges that HHS Secretary…
Audits performed by the HHS Office of Inspector General (OIG) showed that hospitals received excess Graduate Medical Education (GME) Medicare reimbursement after counting residents and interns as more than one…
Providers are calling on CMS to not finalize a proposal to collapse Medicare reimbursement for evaluation and management (E/M) visits into a single, blended payment rate for E/M Levels 2…
CMS recently finalized a rule that will shift the Medicare payment system for skilled nursing facilities (SNF) away from fee-for-service and toward value starting in 2019. The federal agency will…
Current Procedural Terminology (CPT) codes used for medical billing did not account for all the care provided by primary care physicians in about 60.3 percent of visits, a recent Journal…
Implementing claim denials management best practices is key to ensuring hospitals maximize claims reimbursement revenue and prevent denials. Healthcare cost control continued to top hospital priority lists in 2017. But…
Most hospitals gained at least $1.5 million in healthcare revenue after clinical documentation improvement implementation, a Black Book survey found. Nearly 90 percent of hospitals with 150 or more beds…
Unreliable provider communication leaves patients vulnerable to expensive and potentially harmful medical errors, delays the medical billing process, and distorts quality of care. Reducing claims reimbursement waste demands a closer…