In Billing
Jun 29th, 2012
Medicare Payment Advisory Commission’s (MedPAC) June 2012 “Report to the Congress: Medicare and the Health Care Delivery System” has been released. The six-chapter report evaluates Medicare payment issues and makes recommendations to Congress regarding access to care, quality of care, and other issues affecting Medicare. MedPAC Reports on Health Care Delivery System was last modified: ...
In Billing
Jan 27th, 2012
Two decades of demonstration projects aimed at reducing Medicare expenditures and improving patient care have failed to produce meaningful results, according to a Jan. 18 Congressional Budget Office (CBO) report, “Lessons from Medicare’s Demonstration Projects on Disease Management, Care Coordination, and Value-Based Payment.” The CBO pointed to the fee-for-service payment model as the primary reas...
In CMS
Dec 30th, 2011
The Centers for Medicare & Medicaid Services (CMS) would like to reintroduce the concept of the “house call” to modern medicine with a new demonstration project. Under the “Independence at Home Demonstration,” participating practices will provide home-based primary care to targeted chronically ill Medicare patients for a three-year period. In-home visits will be tailored to an ...
In CMS
Sep 16th, 2011
Each year, the Medicare Fee-For-Service (FFS) Program makes billions of dollars in estimated improper payments. The Centers for Medicare & Medicaid Services (CMS) employs several types of Medicare review contractors to measure, prevent, identify, and correct these improper payments. Review contractors find the improper payments by requesting medical documentation from each provider who submitt...
Jul 1st, 2011
Replace bad coding habits with good ones to get the best possible reimbursement. By Jacqueline Nash-Bloink, MBA, CPC-I, CPC, CMRS Hierarchical Condition Category (HCC) coding is a method of determining reimbursement based on the patient’s diagnosis. Generally, the more severe the diagnosis, the higher the reimbursement. HCC coding differs from CPT®-based evaluation and management (E/M) ...