Category: Medical Billing

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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A View into Proposed Medicare PFS and Policy Changes for 2021

The Centers for Medicare & Medicaid Services (CMS) in the past week has proposed Medicare payment rules for outpatient services and physicians for 2021 and finalized payment rules for inpatient rehabilitation facilities (IRFs) and psychiatric facilities. Looking specifically at the 2021 Physician Fee Schedule (PFS) proposed rule, scheduled to be published Aug. 17, it had […]
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CMS Updates Medicare Billing Rules for 20% Add-On COVID-19 Payment

In addition to Medicare billing updates, the federal agency also announced that it will resume routine inspections for all Medicare and Medicaid-certified providers. Claims eligible for the 20 percent add-on payment for COVID-19 hospitalizations will now have to have a positive laboratory test documented in the patient’s medical record, according to recent Medicare billing updates […]
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Billing and Documentation Guide for Patient Care During COVID-19 Pandemic

The COVID-19 pandemic has brought about robust changes to the traditional practice of healthcare in the United States. In a time of social distancing and widespread quarantining, regulatory bodies, including the Centers for Medicare & Medicaid Services (CMS), have adapted to the current environment. The most critical goal was to allow healthcare providers to appropriately […]
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Don’t Let Telehealth Claims Derail Your Accuracy Rates

Know what to look for when auditing telehealth services rendered during the COVID-19 pandemic. In October of 2019, I presented a telehealth webinar entitled “Foolproof Tips for Billing Telehealth Services.” I talked quite a bit about the telehealth guidelines that were current at the time and made note that “by next year, telehealth is expected […]
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Providers Support Value in Health Care Act that Amends MACRA Payment Model

Among other provisions, the bill extends the 5% advanced APM bonus for an additional six years and modifies thresholds to achieve the bonus. Thirteen national provider groups support the newly-introduced House bill, the Value in Health Care Act of 2020, a bipartisan effort that proposes to make changes to the Medicare Access and CHIP Reauthorization Act (MACRA) […]
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How a Pandemic Impacts HIPAA Requirements

As healthcare business professionals, we have been trained in the importance of following HIPAA privacy and security requirements. As coders, auditors, and health information services professionals we are bound by the HITECH Act of 2009, which outlines the responsibilities of “business associates” with respect to HIPAA requirements. As business associates, we are required to “appropriately […]
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Post COVID-19: Medical Billing Finally Realizes the Value of Text-to-Pay

Contactless payments were on the rise even before COVID-19 hit. But now, health systems should see them as essential. Consumers are increasingly wary of touching a credit card terminal that others have used, a perfect conduit for spreading germs. For consumers, text payments serve as a convenient contactless way to pay, but there are other unique benefits […]
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Emerging Opportunities – And Risks – With Telehealth In The Age Of COVID-19

As is painfully obvious to even the most casual of observers, the COVID-19 public health emergency has been disruptive to all industries. And, the healthcare industry has been at the epicenter of this disruption. Nonetheless, not all disruption is negative. One bright spot for many healthcare practitioners during this public health crisis has been the […]
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