Category: Blog

AHA Coding Clinic Now Available

AHA Coding Clinic Now Available

Spring brings Coding Clinic Guidance. Spring has sprung, and that brings the first American Hospital Association (AHA) Coding Clinic on ICD-10-CM/PCS issue of 2022. There are a wide range of topics and guidance. Now that we are receiving biannual coding updates, we begin April this year with some new codes, and some changes that are […]
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Value-Based Payment Models Associated with Lower Acute Care Use

Value-Based Payment Models Associated with Lower Acute Care Use

Medicare Advantage beneficiaries who received care under value-based payment models, including two-sided risk models, saw lower acute care use than beneficiaries under a fee-for-service model. Medicare Advantage beneficiaries whose primary care organization participated in a value-based payment model saw lower rates of hospitalizations, observation stays, and emergency department visits, according to a study published in […]
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Medicare Patients Received 54.5M Office Visits Via Telehealth in 2020

Medicare Patients Received 54.5M Office Visits Via Telehealth in 2020

Office visits represented 48 percent of all telehealth services used in the first year of the pandemic, making it the service most accessed via telehealth, federal data shows. Medicare beneficiaries most often used telehealth for office visits in 2020, receiving 54.5 million virtual office visits in the first year of the COVID-19 pandemic, according to […]
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AMA Urges Congress to Update Medicare Physician Payment System

AMA Urges Congress to Update Medicare Physician Payment System

The American Medical Association urged congressional leaders to lift the freeze on Medicare physician payments and provide updates that reflect inflation and practice costs. Following a recent Medicare Payment Advisory Commission (MedPAC) report, the American Medical Association (AMA) has asked Congress to update the Medicare physician payment system to include a stable annual payment rate […]
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Healthcare Tech Company Launches Online Price Transparency Tool

Healthcare Tech Company Launches Online Price Transparency Tool

Through the online price transparency tool, users can view hospital service prices and assess machine-readable file completeness. A healthcare technology company has launched an online price transparency tool that allows consumers to compare hospital costs before seeking care. Turquoise Health’s Price Transparency Scorecard lets consumers find prices by searching for specific services or providers. The […]
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Hospitals Saw Substantial Underbilling for Medicare Telestroke Services

Hospitals Saw Substantial Underbilling for Medicare Telestroke Services

One-third of hospitals across the country offered telestroke services, but less than 40 percent submitted Medicare telestroke claims in the year before the COVID-19 pandemic. Following the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare claims for telestroke services increased in rural and urban emergency departments. However, there was still substantial underbilling from hospitals with […]
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AHA Asks CMS to Waive Medicare Advantage Prior Authorization During PHE

AHA Asks CMS to Waive Medicare Advantage Prior Authorization During PHE

CMS encouraged Medicare Advantage plans to waive prior authorizations during the public health emergency, but AHA urged the agency to make it a requirement instead of a suggestion. The American Hospital Association (AHA) has asked CMS to work with Congress and require Medicare Advantage plans to waive prior authorization processes during the current and future […]
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