Category: Medical Billing

Congress Takes Steps to Curb Unexpected Medical Bills

Congress Takes Steps to Curb Unexpected Medical Bills

Most Americans tell pollsters they’re worried about being able to afford an unexpected medical bill. Late Monday, Congress passed a bill to allay some of those fears. The measure is included in a nearly 5,600-page package providing coronavirus economic relief and government funding for the rest of the fiscal year. Specifically, the legislation addresses those […]
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Congress Provides Relief on Medicare Payment; Passes Surprise Billing

Congress Provides Relief on Medicare Payment; Passes Surprise Billing

  The $1.4 trillion omnibus legislative package passed by Congress late Monday includes COVID-19 related relief for physicians, imposes new restrictions on surprise billing, and funds the government through fiscal 2021, which ends Sept. 30. The legislation mitigates budget neutrality cuts that would have slashed physician Medicare payment rates by 10.2% and extends the moratorium on the […]
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CMS Provides Updated Guidance on Billing For Covid-19 Monoclonal Antibody Treatments

CMS Provides Updated Guidance on Billing For Covid-19 Monoclonal Antibody Treatments

  CMS updated its COVID-19 billing FAQs on October 28 to address billing scenarios for potential monoclonal antibody treatments. The two new FAQs, which appear in section BB. Drugs and Vaccines under Part B, address billing for monoclonal antibody treatments provided in the hospital outpatient setting. CMS notes that if a monoclonal antibody product is granted an […]
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Updates on COVID-19 Billing and CS Modifier Audits

Updates on COVID-19 Billing and CS Modifier Audits

The pandemic continues to impact Medicare reimbursement. COVID-19 continues to make news on the regulatory front with two new directives from the Centers for Medicare & Medicaid Services (CMS), centering on testing for the deadly coronavirus and formal coding edits for the Medicare Administrative Contractors (MACs) on payments with the CS modifier. There’s a new […]
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Take a Consumer-Oriented Approach to Your Billing Cycle

Take a Consumer-Oriented Approach to Your Billing Cycle

The Covid-19 pandemic is transforming how physicians practice medicine and bill for it. Physicians who take a consumer-oriented approach to their billing cycle may adapt the best, says John Behn III, MPA, president of Stroudwater Revenue Cycle Solutions and a principal of Stroudwater Associates, a national healthcare consulting firm based in Portland, Maine. “We’ve seen […]
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Labs Welcome CMS Rate for Coronavirus Antibody Testing

Labs Welcome CMS Rate for Coronavirus Antibody Testing

CMS set the reimbursement rate for Medicare Administrative Contractors covering the main type of coronavirus antibody test at approximately $42, per an update Tuesday. That rate exceeds investment firm William Blair’s $25 estimate for the category of tests, boding well for future reimbursement policy for antigen testing, analysts noted. Last month, the agency doubled its reimbursement for high-throughput molecular […]
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Patient-Friendly Medical Billing to a COVID-19 World

Adapting Patient-Friendly Medical Billing to a COVID-19 World

Monument Health in South Dakota is adapting to a new definition of patient-friendly medical billing as COVID-19 transforms patient needs and their ability pay for healthcare. Patient financial responsibility has been impacting the hospital revenue cycle far before the world knew what COVID-19 was. But the unprecedented public health crisis has shed new light on patient-friendly […]
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New Billing Basics for Telemedicine

New Billing Basics for Telemedicine

Betsy Nicoletti, MS, a nationally recognized coding expert, will take your coding questions via email and provide guidance on how to code properly to maximize reimbursement. Have a question about coding? Send it here. In this column, Nicoletti outlines some key guidance for using telemedicine. These rules would apply during the Centers for Medicare & Medicaid […]
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Regulations on SNF Waivers and Telehealth

COVID-19 Impacts Regulations on SNF Waivers and Telehealth

As with last week, RACmonitor asked Dr. Ronald Hirsch, vice president of R1 RCM, to summarize the most pertinent regulatory changes recently arising. The following is a transcript of his reporting today on Monitor Mondays. “First, thank you, everyone, for continuing to care for patients and continuing to take this pandemic seriously,” Dr. Ronald Hirsch […]
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