Tag: Claims Reimbursement

Hospital Pros and Cons of the CY 2022 OPPS Proposed Rule

Hospital Pros and Cons of the CY 2022 OPPS Proposed Rule

Hospital groups are digesting the 863-page CY 2022 OPPS proposed rule, but many are already commenting on new hospital price transparency penalties and other policies. The newly proposed Medicare Outpatient Prospective Payment System (OPPS) rule for calendar year (CY) 2022 is causing a stir with new hospital price transparency enforcement rules and other policies. The […]
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HRSA_ Over 5M Claims Paid for Uninsured COVID-19 Vaccinations

HRSA: Over 5M Claims Paid for Uninsured COVID-19 Vaccinations

The Health Resources and Services Administration (HRSA) has paid over 5 million claims for COVID-19 vaccinations of uninsured Americans, according to a recent announcement. The claims were paid through the HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured, a program funded by pandemic-related legislation […]
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New CPT Code Expands COVID-19 Coding, Billing to Antigen Tests

New CPT Code Expands COVID-19 Coding, Billing to Antigen Tests

The AMA’s new Category I CPT code will allow for COVID-19 coding and billing of antigen tests performed on patients suspected of being infected by the novel coronavirus. The American Medical Association (AMA) recently updated Current Procedural Terminology (CPT) to enable proper COVID-19 coding and billing of antigen tests performed on patients suspected of being infected with […]
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Medicare Reimbursement for Telehealth Services

Providers Want Equal Telehealth Reimbursement Beyond COVID-19

With telehealth reimbursement flexibilities set to expire following the public health emergency period, providers are calling on HHS and policymakers to continue payment parity beyond COVID-19. Telehealth use has increased dramatically in a matter of weeks, enabling providers to continue seeing patients despite social distancing and shelter-at-home restrictions due to COVID-19. But these advancements could […]
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Medical Billing Issues Due to COVID-19

Documentation to Ease Medical Billing Issues Due to COVID-19

A healthcare lawyer advises providers to thoroughly document care delivery to prevent medical billing and payment issues likely to arise from the COVID-19 pandemic. Clinical documentation is critical to serving patients with COVID-19, but also avoiding medical billing and payment issues in the months and years following the pandemic, according to healthcare lawyer Delphine O’Rourke. “There’s […]
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Strategies to Mitigate Shrinking Reimbursement in Emergency Medicine

Strategies to Mitigate Shrinking Reimbursement in Emergency Medicine

Emergency departments are under intense pressure to do more with less, and drilling down into clinical and operational data can provide opportunities to offset decreasing revenues Many emergency providers are starting to find themselves caught within a perfect storm, with pressure from reduced reimbursements building steadily across all payer types. Medicare payments for emergency care have effectively […]
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Medicare Payment Updates

CMS Proposes FY 2020 Medicare Payment Updates For Post-Acute Care

Recently proposed rules would boost FY 2020 Medicare payment rates for several post-acute providers, including skilled nursing facilities and hospices. April showers bring May flowers. But, this year, they are also bringing a slew of new Medicare payment rate proposals, including reimbursement and quality reporting updates for several types of post-acute care providers. CMS recently […]
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