In Audit
Nov 1st, 2018
By law, the Administrative Law Judge level of Appeals has 90 days to resolve appeals submitted to the ALJ level.  However, the Department of Health and Human Services (HHS) Office of Hearings and Appeals (OMHA) has been unable to keep up with the number of appeals submitted to them which has lead to a huge ...
In CMS
Oct 30th, 2018
The government wants to lower Part B drug costs by matching them to international prices, but it’s neither going to be immediate nor easy. Reigning in Drug Prices In addition to industry efforts make medicines more affordable, the Centers for Medicare & Medicaid Services (CMS) announced it is soliciting public comments on a plan and ...
In Billing
Oct 23rd, 2018
Are your clinicians reporting patient relationship codes on their Medicare Part B claims? The HCPCS Level II modifiers are voluntary this year, making it a good time to get in practice. What Is the Purpose of Patient Relationship Categories and Codes? The Medicare Access and CHIP Authorization Act of 2015 (MACRA) requires the Centers for ...
Oct 22nd, 2018
Deloitte did a 2018 survey of U.S. healthcare consumers and physicians, and found: 90 percent of physicians see the benefits of telemedicine technology but only 14 percent have the ability to perform video telemedicine visit capabilities right now. Of the remainder, only 18 percent plan on adding the capability over the next few years. Of ...
In CMS
Oct 10th, 2018
The Department of Justice preliminary OK’d the merger between pharmacy giant CVS and insurance stalwart Aetna. What does this new model of healthcare mean to medical coders and the industry? CVS & Aetna Symbiotic Partners Aetna will take advantage of CVS’ huge network of locations, all of which distribute pharmaceuticals and most of which have some level ...