Tag: Healthcare Reform

Prior Authorization Challenges

5 strategies to address Prior Authorization Challenges

Prior Authorization Challenges are a growing hurdle for medical practices dealing with Medicare Advantage plans. Recent investigations reveal concerning trends: improper denials and a lack of transparency from some insurers. This can significantly delay or even block essential care for patients. The Problem with Prior Authorizations Improper Denials: A government investigation found that Medicare Advantage […]
Learn More
Allzone-Chiropractic-Billing

8 Chiropractic Billing Tips to Boost Revenue

Chiropractic billing tips: Running a successful chiropractic center involves more than just delivering exceptional patient care. A critical yet often overlooked aspect is ensuring a smooth and efficient billing process. With a constant flow of patients, managing insurance complexities and ever-changing regulations can quickly become overwhelming. 8 key chiropractic billing tips to keep your Revenue […]
Learn More
Authorization Denials

Stop Authorization Denials in Tracks

Getting bogged down by authorization denials? You’re not alone. Here, we explore common roadblocks and effective strategies to keep your revenue flowing smoothly. Challenge: Drowning in Last-Minute Authorizations Solution: Divide and Conquer with a Multi-Team Approach Separate teams can tackle present and future authorizations. The “Today” team verifies benefits and identifies authorization needs for upcoming […]
Learn More
New Billing Codes-for Prior Authorization Work Proposed by AMA

New Billing Codes for Prior Authorization Work Proposed by AMA

New billing codes: Medical experts might consider creating new billing codes for the time doctors and their support staff spends working on prior authorizations. The American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Board meets May 9-11 in Chicago. On the meeting’s agenda are three potential new CPT codes “for reporting services (physician, QHP, […]
Learn More
Site-neutral-A-solution-to-lower-healthcare-costs

How Implementing Site-Neutral Policies Can Help Reduce Healthcare Costs

The United States grapples with a healthcare affordability crisis, anticipating a 6.5 percent surge in costs due to inflation next year. Amidst concerns over escalating medical expenses, the deeper roots of these inflated prices often evade attention. Deficient government policies, notably Medicare reimbursement policies, contribute to consolidating the healthcare sector, ultimately driving up costs that […]
Learn More
wide range of Health care bill would impact physicians

Health care bill with a wide range of provisions would impact physicians

The Senate Finance Committee proposed that the full chamber should review a legislation that could instigate alterations in physician practices. This proposition was discussed during a 90-minute meeting on November 8, 2023, regarding the bill named “The Better Mental Health Care, Lower-Cost Drugs, and Extenders Act.” This bill encompasses diverse aspects of healthcare, including mental […]
Learn More

CMS Issues Long-Awaited, Controversial Final Rule on Price Transparency

A long-awaited and controversial final rule on healthcare price transparency was released Thursday by the federal government. The rule, mandated under a June 2019 executive order by President Donald Trump, requires private group health plans and individual health insurance market plans to disclose pricing and cost-sharing information in a consumer-friendly format. The mandate, which takes effect on January 1, […]
Learn More

New Rules Issued for Modifiers 59, XE, XS, XP, and XU

The Centers for Medicare & Medicaid Services (CMS) issued a policy change modification to the claims processing logic for Modifier 59 Distinct procedural service (and the optional patient-relationship modifiers XE, XS, XP, and XU) on February 15, 2019. These modifiers are only processed when applied to the Column 2 code in a bundled pair, per Correct Coding Initiative […]
Learn More

5 Ways to Ensure RCM Efforts Don’t Leave Money on the Table

A frequent knock on electronic health records has been that they’re just glorified billing systems that fail to provide enough clinical functionality to make a significant difference in quality of care. So it’s somewhat incongruous that a recent Black Book report on revenue cycle management (RCM) system adoption would say that 26 percent of hospitals […]
Learn More