Category: Revenue Cycle Management

MA Reimburses 2X Medicare Rate for Some COVID-19 Vaccinations

MA Reimburses 2X Medicare Rate for Some COVID-19 Vaccinations

Healthcare providers in Massachusetts are getting twice the standard Medicare rate for COVID-19 vaccinations in an effort to accelerate vaccine rollout, according to a recent provider bulletin from the state’s Medicaid office. The provider bulletin released in January 2020 states that providers administering the two-dose vaccines from Pfizer and Cambridge, Massachusetts-based Moderna will receive $33.88 for the […]
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Denials Management Versus Denials Avoidance_ CDI Can Capitalize

Denials Management Versus Denials Avoidance: CDI Can Capitalize

  Typical CDI programs are intended to drive reimbursement through diagnosis securement, contributing to improved case mix index. The COVID-19 pandemic is placing monumental financial stressors upon hospitals, with added costs to treat patients with high acuity and long length of stays, coupled with significant revenue loss associated with postponement of more profitable elective surgeries, […]
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The Importance of Data Security in Medical Facilities

  Today, data breaches, ransomware attacks, and identity theft are endangering privacy and well-being. This is true for medical data because if malicious hackers get access to it, human lives and health could be at stake. Scammers may also attempt to benefit from ongoing events to disrupt the data gathering process for healthcare corporations. Medical […]
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CMS to Reprocess Some Outpatient Claims After Site-Neutral Ruling

CMS to Reprocess Some Outpatient Claims After Site-Neutral Ruling

CMS has announced that it will reprocess hospital outpatient claims from last year for clinic visit services provided at excepted off-campus provider-based departments. The agency will start reprocessing the claims in July 2021 in order to pay all hospitals the same rate as non-excepted off-campus provider-based departments for clinic visit services paid under the Physician Fee Schedule, […]
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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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