In the realm of medical billing and coding, the incorporation of artificial intelligence stands as a pivotal advancement. Its role in healthcare establishments is to optimize billing procedures, thereby mitigating costly errors. Among the array of AI-driven technologies, machine learning and Natural Language Processing (NLP) take the forefront. These tools excel at swiftly and accurately […]
Radiology practices that perform interventional procedures have to be up to date on the use of documentation and coding techniques for evaluation and management (E/M) services. Since these current procedural terminology (CPT) codes in the 99xxx range are less commonly utilized in many radiology practices, identifying circumstances where E/M services are billable and then properly […]
This new law is set to take effect on Jan. 1, 2022. In the closing days of 2020, Congress enacted and the President signed into law the “No Surprises Act.” But what does that mean for providers and patients exactly? The Act contains key protections to hold consumers harmless from the cost of unanticipated […]
For several, it is hard to envision the future of Revenue Cycle Management (RCM) in the Artificial Intelligence (AI) era. How does this technology accelerate the business cycle and affect healthcare back-office day-to-day work? It is unknown when AI will be the industry norm at this stage, but there is some speculation about potential advantages […]
Payment collection continues to be a challenge for healthcare providers. As we previously reported for Physician’s Practice, studies have indicated that doctors only collect 12% of what they are owed at the time of service, and in two out of three visits they collect nothing upfront at all. This means that physicians are sending bills to collect […]
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 […]
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 […]
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 […]
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 […]
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 […]










