It is estimated that as high as 80 percent of medical bills contain errors.1 As healthcare costs continue to rise, so too is the need for healthcare payers to reduce overspending resulting from avoidable billing errors and improper claims reimbursement. Given the sheer volume of claims submitted each day, capturing and reconciling discrepancies based off of […]
HIV/AIDS payments, in particular, are under the microscope. The new Patient-Driven Payment Model, or PDPM, makes radical changes to the Medicare payment model for nursing homes. One of the largest changes is the reimbursement rate for services provided to HIV and AIDS patients. In 2016, there were 15,807 deaths among people with diagnosed HIV in […]
A physician assistant (PA) serves as an assistant surgeon only to suture and close an incision. There is no documentation that the PA performed any other function to assist the primary surgeon during the surgery performed on the Medicare patient, such as providing extra hands needed for tasks which required more than the surgeon’s two […]
CMS has provided ICD-10-PCS updates for fiscal year 2020 that include 2,056 deletions. Here are 20 of the deleted codes: 0370046 – Dilation of right internal mammary artery, bifurcation, with drug-eluting intraluminal device, open approach 0372046 – Dilation of innominate artery, bifurcation, with drug-eluting intraluminal device, open approach 0374056 – Dilation of left subclavian artery, bifurcation, with […]
Discover the must-watch list for coding bug bites, poison ivy, and heatstroke! Get ICD-10 pointers. Can you believe it’s already mid-August? While the buzz around 2020 code updates is in the air, let’s not forget about the remaining summer of 2019. How many of these common warm-weather diagnoses have you encountered and coded this year […]
Providers are encouraged to file protective appeals. “In section XI of the preamble of the proposed rule, we discussed the growing number of Provider Reimbursement Review Board (PRRB) appeals made by providers and the action initiatives that are being implemented with the goal to decrease the number of appeals submitted; decrease the number of appeals […]
An overview of the proposed Medicare Physician Fee Schedule: The proposed Medicare Physician Fee Schedule (MPFS) rule for 2020 was officially released on Aug. 14, 2019, encompassing various elements. Among these are proposals such as adjusting the PFS conversion factor to $36.09, introducing new HCPCS codes for bundled episode-of-care treatment for opioid use disorders, revising […]
The Centers for Medicare & Medicaid Services (CMS) knows that a significant amount of money is being overpaid to insurance companies in the Medicare Advantage program, but they have yet to recover these overpayments. That’s about to change. CMS says it will increase the audits being performed on Medicare Advantage risk-adjusted code submissions and apply […]
Allzone Management Services, Inc. is pleased to announce that it will be exhibiting at the HBMA 2019 Healthcare Revenue Cycle Conference from September 12th to September 14th, 2019 in Las Vegas, NV. Allzone Management Services, a California-based End-To-End Revenue Cycle Management Services Provider Company serving 70+ clients across the United States, today announces it will showcase […]
Several changes to the Merit-based Incentive Payment System (MIPS) track of the Quality Payment System (QPP) are outlined in a proposed rule for 2020 revisions to payment policies under the Physician Fee Schedule (PFS). Most of the proposed changes come as no surprise, but there is one proposal, in particular, that will make a huge impact on […]