AHA, AMA sue Biden admin to challenge surprise billing arbitration process

The American Hospital Association (AHA) and the American Medical Association (AMA) have filed a joint lawsuit against the federal government, challenging the Biden administration's implementation of the No Surprises Act.…

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New York proposes surprise billing crackdown

The New York State Department of Financial Services wants health insurers to pay any extra bills when their out-of-date provider directories send patients to out-of-network doctors and hospitals. The state…

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High Deductibles Associated with More Medical Bill Problems

In the year and a half following the Affordable Care Act’s first marketplace open enrollment period, the number of families who had trouble paying medical bills decreased by nearly 10…

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How data intelligence will drive precision healthcare in the NHS

As the NHS evolves, many trusts are developing into digitally mature systems, shifting away from the paper-dominated organizations they once were. With the implementation of electronic health records (EHRs), it has…

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Read more about the article CMS Releases Physician Fee Schedule Final Rule
Displeased black healthcare worker using smartphone and reading an e-mail at doctor's office.

CMS Releases Physician Fee Schedule Final Rule

CMS says it the goal is to support health equity while focusing on high-quality person-centered care. Increased leverage of telehealth for behavioral care, diabetes prevention and mitigation, and enhanced payment…

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The Impact of Coding on Maternal Outcomes

This area of coding is not so easy. While most maternal deaths are preventable, the rate has been increasing in the United States since 2000. As a matter of fact,…

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ROI realized from pre-bill review of documentation and coding

Involving physicians in the mid-revenue cycle process can increase hospital ROI by 700%, according to Enjoin CEO Dr. James Fee. Hospitals and health systems can improve revenue through a pre-bill…

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Medical Coding Slip at TX Hospital Led to COVID-19 Billing Error

Midland Memorial Hospital agreed to pay over $555,000 for a medical coding error that resulted in claims being sent out for reimbursement from the government even though patients did not…

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CMS Income Sharing Changes Creating Confusion

Physician groups are now permitted to subdivide into groups of at least five physicians apiece – and that’s the root of the problem. One of the provisions in the changes…

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Medicare Advantage and TPE Audits Surge

Everyone in the industry knows about audits of healthcare providers. But what about the billing companies? Or a data-analytics company? In a complaint filed last week, a New York data-mining…

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CMS Asks Medicare Advantage Plans to Relax Prior Authorizations

CMS has requested that Medicare Advantage organizations relax or waive prior authorizations due to the impact of the coronavirus Delta variant. “The ability of hospitals to transfer patients to appropriate…

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Learn about 4 new CPT codes to bill for collaborative care

Your practice is considering making a move—or has moved—to a collaborative care model so patients have greater access to mental health care in the primary care setting. It’s a model…

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