On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules. In keeping with states’ increasingly…
Even though they may have health insurance, growing numbers of Texas consumers are getting unexpected bills from doctors not in the consumers’ health care network. A public policy group told…
Q: Our office is having a difficult time reaching patients within the required two business days from discharge for transitional care management (TCM) codes. Will this preclude us from billing…
The Centers for Medicare and Medicaid Services (CMS) released a technical alert dated May 23, 2016 related to Non-Group Health Plan (NGHP) MMSEA Section 111 reporting. This alert communicates that…
The KVUE Defenders uncovered more concerns involving medical billing transparency following a nation-wide investigation. This time, complaints involve hospitals and other health care providers not providing reasonable cost estimates upfront…
CMS' Medicare Access & CHIP Reauthorization Act of 2015 replaced the current Meaningful Use, Physician Quality Reporting System and Value-Based Payment Modifier this year. Under MACRA, physicians can participate in…
Q: Much to our surprise, the transition to ICD-10 continues to go relatively smoothly. Our organization has had minimal denials and delays in cash flow. Is our experience unique, or…
Raleigh Orthopaedic Clinic of North Carolina has agreed to pay $750,000 to settle charges that it might have violated the HIPAA Privacy Rule by disclosing protected health information (PHI) for…
As the largest outsource coding provider in the country we have identified trends and gained unique insights from our coders throughout the transition to ICD-10. We are sharing these insights…
When you’re an entrepreneur, you do a lot of searching for the right candidates to join your team. Hiring takes up a tremendous amount of time, so one of the…
How can medical practices work effectively with payers to receive payment? Business News Daily sought answers from healthcare experts. Here are six tips: 1. Fill out claims, well. Make sure…
Louisiana posted the highest rate of Medicare being overbilled for services in the nation in 2015, with providers charging an estimated $1.25 billion more than they should have, according to…
Physicians often say they feel like the rules, standards and policies regarding the way they practice medicine change all too frequently. In 2016, there are several key issues physicians should…
Some experts are predicting a large spike in denials beginning on Oct. 1, 2016 when the Centers for Medicare and Medicaid Services will require claims to be more specific. Forward-looking…
Helping patients meet their financial obligations will, in turn, allow healthcare organizations to protect their valuable revenue streams in a time of financial change. With the ICD-10 conversion behind us,…
Just as the Ice Age eventually ended, so has the ICD-10 coding freeze. CMS recently announced that roughly 6,000 new codes will be added this October, which will be the…