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…
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…
CMS has officially rescinded a final rule published by the Trump Administration that would have expedited the Medicare coverage process for breakthrough devices.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…
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…
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,…
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…
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…
Outdated billing practices, particularly in hospitals and physician offices, are causing some issues for debt collection firms as they revamp their consumer communication practices as required by law, Bloomberg Law…
Various approvals, exceptions, and new PCS codes that may potentially lead to additional payments. The Centers for Medicare & Medicaid Services (CMS) desires to use the best data available when…
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…
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…
Both providers and payers have major concerns with how regulations to ban surprise medical bills will be implemented next year, with providers concerned about added burden and insurers clamoring for…
Innovative work to meet the urgent public health need for streamlined reporting and tracking of COVID-19 vaccinations is presented in today’s release of the 2022 Current Procedural Terminology (CPT®) code…
The CMS budget for fraud, waste and abuse has doubled in size from 2021 to 2022. Two years ago, the federal government created a plan to audit Medicare Advantage (MA) insurers more…
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…
Research shows that about 14 percent of adults developed at least one new clinical sequela requiring medical care after recovery from COVID-19, though many specifics have yet to be clarified.…