CMS will increase Medicare payments by $35 per dose to administer at-home COVID-19 vaccines in an effort to increase the vaccination rate among beneficiaries. Medicare payments will increase by $35 per dose for providers who administer at-home COVID-19 vaccinations for Medicare beneficiaries, CMS announced today. In alignment with President Biden’s goal of ensuring vaccine […]
Average claim denial rates are between 6% and 13%, but some hospitals are nearing a “danger zone” after COVID-19, a survey shows. Hospital claim denial rates are at an all-time high, signaling a need for better claims denial management, a recent survey from Harmony Healthcare reveals. The healthcare industry has seen a 20 percent increase […]
Physicians who institute best practices bring in more revenue and profit than those who do not, and this can be the difference between being successful and being out of business. What’s the difference between a highly successful practice and one that just gets by? Oftentimes, it comes down to focusing on a handful of key […]
Without detailed documentation, providers may face an uphill battle in defending themselves from quality audits and even malpractice issues. Up until 2021, at least for the prior two decades, coders and clinicians relied upon the established Evaluation and Management (E&M) guidelines to determine which E&M code was appropriate for each specific encounter. The 1995 guidelines […]
Despite a fiscally challenging year for the healthcare industry, physician compensation for most specialties has remained the same or has slightly increased, a new report from the Medical Group Management Association (MGMA) reveals. However, most specialties showed an overall decrease in productivity in 2020. The report utilized data from 185,000 providers spanning over 6,700 organizations, […]
An industry through leader recaps current challenges to traditional reimbursement models for Medical Economics®. Limited by the slow pace of change in traditional reimbursement models, shifts in the paradigm for patient care have also lagged far behind the possibilities created by transformative technology. The COVID-19 pandemic has changed that, catalyzing improvements in reimbursement by […]
Educated guesses and imprecise, stopgap efforts aren’t enough. Revenue cycles need precise strategies to identify exactly where leakage occurs and implement solid processes to stop leakage before it starts. Even before COVID-19, 250-bed hospitals lost $4.7–$11 million a year from mid–revenue cycle leakage. Now, pandemic-fueled volume losses and razor-thin margins mean that hospitals can no […]
Hospital financial performance improved in April, but margins are still thin as hospital revenue recovers from COVID-19, a report from Kaufman Hall shows. Hospital revenue, volumes, and margins increased in April 2021 both year-to-date and year-over-year, but have a long way to go in terms of COVID-19 recovery, according to a report by health care […]
Miscoding and fraudulent billing can destroy a medical practice. Use these tips to get robust oversight of your medical billing and coding in place. The work billers and coders do for a medical practice plays a large role in its survival. Coders and billers are tasked with translating the care delivered by medical professionals into […]
2022 Hospice proposed rule would help with addendum statement snags, but other problems remain. In the Hospice proposed rule, published in the April 14 Federal Register, the Centers for Medicare & Medicaid Services outlines these changes to the election statement addendum that was implemented on Oct. 1, 2020. Three vs. Five Days In the […]