Even though virtual healthcare has been possible for over a decade, the technology officially became an integral part of the care process as a direct result of COVID-19. Telemedicine can offer on-demand medical attention to patients anytime and anywhere, but it’s essential for virtual care to be easily accessible to anyone who needs it. True […]
The Trump administration has finalized a rule aimed at boosting access to home dialysis and translation for patients with end-stage renal disease. The Centers for Medicare & Medicaid Services estimates that the End-Stage Renal Disease Treatment Choices Model will save Medicare $23 million over the next five years. The value-based model is designed to incentivize providers to […]
Telehealth reimbursement expansions granted during the PHE may be limited to providers in Advanced APMs moving forward to prevent program integrity issues, MedPAC said at a recent meeting. The Medicare Payment Advisory Commission (MedPAC) is the latest group to weigh telehealth reimbursement expansions after the COVID-19 pandemic. In a meeting held virtually last week, MedPAC analysts Ariel […]
Erratic claim volumes and confusion over COVID-19 coding and claim requirements are the top issues impacting revenue cycle operations, according to a new survey of financial leaders at US hospitals and health systems. Conducted through the Healthcare Financial Management Association’s (HFMA) Pulse Survey program, the survey commissioned by Alpha Health asked 587 chief financial officers and revenue cycle leaders […]
Providers need a mechanism to be accurately reimbursed for the time and effort that they expend in providing care. Evaluation and Management (E/M) leveling has been the standard method in which to provide appropriate, defensible payments for services. However, it has been successfully argued that the 1995 and 1997 E/M guidelines in place today are […]
CMS will leverage existing evaluation and management (E&M) payment codes to reimburse eligible providers for the coronavirus counseling services.  The Centers for Medicare & Medicaid Services (CMS) will make payment available to physicians and providers for counseling patients at the time of COVID-19 testing about the importance of self-isolation after they are tested and prior to the […]
The American Medical Association (AMA) has recently expanded its Current Procedural Terminology (CPT) code set to include four additional codes for coronavirus testing. These new codes facilitate providers in reporting a wider range of laboratory tests for the novel coronavirus on medical claims. The newly introduced CPT codes are as follows: •86408: SARS-CoV-2 neutralizing antibody […]
Healthcare is the industry most at-risk during the coronavirus (COVID-19) pandemic. Providers are on the front lines of response efforts. At the same time, the financial implications of the pandemic are also creating significant revenue cycle challenges, putting providers even more at risk during the pandemic. Individuals are postponing non-emergency care for many reasons, from […]
Payers are reimbursing providers for all COVID-19-related testing and treatment they are furnishing to their insured members, but what if the patient is uninsured? Healthcare providers need not write off COVID-19 testing and treatment services rendered to uninsured patients. Compensation is available! The public health emergency for COVID-19 requires the healthcare industry to focus their […]
Deemed the epicenter of COVID-19 deaths by many, skilled nursing facilities and other nursing home providers are now on the verge of collapsing without financial help, industry leaders say. Skilled nursing facilities are on the verge of collapsing due to historic underfunding and the financial repercussion of the COVID-19 crisis, according to a new report from the […]