Category: Revenue Cycle Management

CMS Accelerates Medicare Beneficiaries’ Access to Innovations

CMS Accelerates Medicare Beneficiaries’ Access to Innovations

Medicare beneficiaries now have immediate access to innovative medical technology approved by the U.S. Food and Drug Administration (FDA), rather than having to wait for it to clear additional bureaucratic hurdles before coverage is approved. The Medicare Coverage of Innovative Technology (MCIT) final rule issued this week eliminates the time and cost innovators were formerly […]
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Physician Fee Schedule Updates May Increase Reimbursement, Time with Patients

Some updates to the evaluation/management codes on the 2021 Physician Fee Schedule will provide greater reimbursement to physicians and allow them to spend more time with patients, CMS and medical societies said. According to CMS, the code sets that it is finalizing will increase the value of certain services. These include: cognitive impairment assessment and care […]
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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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How AI is Solving Big Challenges During COVID-19

How AI is Solving Big Challenges During COVID-19

Artificial intelligence is changing the way we think about healthcare during the COVID-19 pandemic, opening our eyes to new opportunities to use machine learning to draw useful conclusions faster. Before COVID-19, one of the biggest challenges healthcare organizations faced was how to accelerate and scale their application of AI—clinically and operationally. Now, the use cases […]
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CMS Finalizes Additional Payment for New COVID-19 Treatments

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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