Tag: Healthcare Payment

Six Tips to Getting Paid for CPT Modifiers

Six Tips to Getting Paid for CPT Modifiers

In medical coding, CPT modifier are vital for accurate reimbursement of healthcare services. These special codes, attached to primary procedure codes, provide additional details about the complexity or extent of a service. However, using modifiers incorrectly can lead to claim denials and lost revenue. This blog post shares six key tips to help you get […]
Learn More
Value-Based Payment Models Can Limit Healthcare Spending

Value-Based Payment Models Can Limit Healthcare Spending

Value-based payment models, including accountable care organizations, bundled payment models, and capitation models, can generate savings for providers and limit healthcare spending. As healthcare spending escalates in the US, stakeholders have started looking at value-based payment models to address rising costs, but many payments are still tied to fee-for-service models, according to a Health Affairs […]
Learn More
5 Tax traps physicians should avoid

5 Tax traps physicians should avoid

With Tax Day on the horizon, don’t fall into these specific traps. Our last installment provided some details and basic rules every doctor should know about tax planning, including who is responsible for the information on your tax return, details about what income you have to report, and a look at the sales techniques promoters […]
Learn More
How Population Health, Risk Stratification Support Value-Based Care

How Population Health, Risk Stratification Support Value-Based Care

To excel in value-based care, providers must lean on strategies for managing population health and skillful risk stratification. Amid the COVID-19 pandemic, organizations observed the ramifications of fee-for-service, leading to communication and revenue challenges for both providers and patients. While value-based care is not a novel idea, the pandemic greatly accelerated the adoption of this […]
Learn More
CMS Releases Physician Fee Schedule Final Rule

CMS Releases Physician Fee Schedule Final Rule

  CMS says it the goal is to support health equity while focusing on high-quality person-centered care. Increased leverage of telehealth for behavioral care, diabetes prevention and mitigation, and enhanced payment for vaccine administration were three out of many priorities cited by federal officials who announced the release of the Centers for Medicare & Medicaid […]
Learn More
Key Ways Providers Can Prepare for New Surprise Billing Rules

Key Ways Providers Can Prepare for New Surprise Billing Rules

Starting January 1, 2022, healthcare providers will be subject to a new surprise billing law that makes it illegal for providers to bill patients more than in-network cost-sharing for out-of-network services and establishes an arbitration process to resolve unexpected out-of-network charges. The law, the No Surprises Act, was passed in December 2020 as part of […]
Learn More
Benefits of HIPAA-Compliant Emails

Benefits of HIPAA-Compliant Emails

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 […]
Learn More
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 […]
Learn More
x