Category: Revenue Cycle Management

Predictive Healthcare Forecasting Key to Provider Survival in 2021

Predictive Healthcare Forecasting Key to Provider Survival in 2021

Healthcare forecasting that can adapt quickly to changes could be as critical to a provider organization’s survival in 2021 as wearing a mask to stop the spread of COVID-19, experts at PwC’s Health Research Institute are saying. Nearly three-quarters of healthcare executives (74 percent) recently surveyed by the Health Research Institute said their organizations would […]
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CMS Updates Part B Payment Information For Covid-19 Treatments

CMS Updates Part B Payment Information For Covid-19 Treatments

A version of this article was first published December 16, 2020, by HCPro’s Revenue Cycle Advisor, a sibling publication to HealthLeaders. CMS released new and updated FAQs on Medicare Part B billing and reimbursement for COVID-19 treatments and vaccines. The information updated December 9 is included in Section BB, Drugs and Vaccines under Part B of CMS’ COVID-19 […]
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CMS Finalizes Additional Payment for New COVID-19 Treatments

CMS’ Fourth COVID-19 Interim Final Rule with Comment Period (IFC-4) includes additional payment for new COVID-19 treatments, price transparency requirements for COVID-19 diagnostic tests, and coverage for potential vaccines among other provisions. Most provisions of IFC-4 became effective November 2. Hospital Payment for New COVID-19 Treatments The New COVID-19 Treatments Add-on Payment (NCTAP) will provide additional Medicare […]
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Coronavirus: CMS Releases Plan For Vaccine Patient Price, Reimbursement

  The Centers for Medicare and Medicaid Services (CMS) is laying the groundwork for the widespread release of a COVID-19 coronavirus vaccine by releasing an interim final rule with comment period (IFC) with information on out-of-pocket patient costs and physician reimbursements. According to a news release, any vaccine which is authorized by the U.S. Food and […]
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Transforming Revenue Cycle Management Using Automation

Transforming Revenue Cycle Management Using Automation

In today’s healthcare industry today, there is a lot of buzz and hype surrounding automation. Large healthcare networks, medical facilities, and revenue cycle management service providers alike are looking to achieve a more efficient, robust revenue cycle through automation technologies. Any technology that can free employees to focus on high-value tasks and make revenue cycle […]
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CMS Issues Long-Awaited, Controversial Final Rule on Price Transparency

CMS Issues Long-Awaited, Controversial Final Rule on Price Transparency

  A long-awaited and controversial final rule on healthcare price transparency was released Thursday by the federal government. The rule, mandated under a June 2019 executive order by President Donald Trump, requires private group health plans and individual health insurance market plans to disclose pricing and cost-sharing information in a consumer-friendly format. The mandate, which takes effect on January […]
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CMS Sets Medicare Reimbursement Rate for COVID-19 Vaccine

CMS Sets Medicare Reimbursement Rate for COVID-19 Vaccine

A new interim final rule with comment period ensures Medicare reimbursement for the administration of a COVID-19 vaccine and provider use of innovative treatments for the novel coronavirus. The rule released last night states that Medicare will pay providers $28.39 for the administration of a single-dose COVID-19 vaccine. In the event an approved COVID-19 vaccine requires multiple […]
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Nine Tips for Collecting Patient Balances

Nine Tips for Collecting Patient Balances

Practices have been creative during COVID-19 to ensure safe patient access: Telephone visits. Curbside immunizations. Drive-up virus testing. Even checking patients in for their in-office visits while they wait in the car. However, each of these scenarios poses one significant challenge: Collecting copayments and coinsurance. “With COVID-19, you’ve got to find ways to meaningfully engage […]
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Clinicians Serving Socially At-Risk at a Disadvantage Under MIPS

Clinicians Serving Socially At-Risk at a Disadvantage Under MIPS

  Clinicians who served more patients with social risk factors such as low income performed worse in the Merit-Based Incentive Payment System’s inaugural payment year, and therefore, received unfavorable value-based reimbursement, according to a new study. The study recently published in Health Affairs found that out of 510,020 clinicians participating in the Merit-Based Incentive Payment System (MIPS) in […]
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