In Billing
Apr 4th, 2019
Hurdles set by commercial carriers require out-of-network groups to tighten billing management and foster full financial transparency. Most non-participating providers learn that out-of-network reimbursement can be higher than in-network reimbursement. The two drawbacks to remaining out of network — higher patient out-of-pocket costs and exclusion from participating provider listings — may be remed...
From front-end to back-end, see where your team can save the most time and money. An efficient revenue management team is vital to your practice’s financial health and sustainability, but it’s critical to have well-documented procedures in place. Realities of Desktop Medicine If you’re spending too much time on administration, you’re not alone. According to ...
In Billing
Oct 31st, 2016
Home health agencies can look forward to a 0.7 percent reduction in Medicare payments in the 2017 Medicare home health prospective payment system (HH PPS). This amounts to a $130 million savings for the agency, but it’s hard to explain: the Centers for Medicare & Medicaid Services (CMS) said the estimated decrease reflects the effects of ...
In Coding
Oct 17th, 2016
Minor procedures (including colonoscopy and endoscopy) have a zero- or 10-day global period and no pre-operative period (other than the day of the procedure). As such, the initial office consultation with the provider to determine the indications and need for an endoscopy, potential risks, type of sedation, preparation, etc., is a billable service, when medically ...
In CMS
Oct 14th, 2016
Medicare will pay for the newest CPT influenza virus vaccine, 90674, the Centers for Medicare & Medicaid Services (CMS) announced in a recent transmittal. But because 2017 codes won’t go into effect until after the first of the year, payments won’t begin until January 3, 2017. However, claims with dates of services on or after August 1, 2016 will ...