Tag: Medicaid

Gender-affirming care coding

Impact of Policy Changes on Gender-Affirming Care Coding

The landscape of healthcare policy in the United States has recently been shaken by an executive order issued by the U.S. President, introducing significant potential shifts, particularly concerning Gender-Affirming Care Coding. This has ignited widespread concerns about insurance coverage, general medical coding practices, and compliance obligations for hospitals and healthcare facilities nationwide. On January 28th, […]
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Survey Reveals Key Issues with Challenging Surprise Medical Bills and Coverage Denials

Survey Reveals Key Issues with Challenging Surprise Medical Bills and Coverage Denials

A new study by the health care system reveals a significant gap in consumer healthcare rights. Despite attempts to curb surprise medical bills, a large portion of insured Americans are still receiving unexpected charges. Adding to this problem is the high rate of coverage denials, leaving patients with substantial out-of-pocket costs and causing financial hardship […]
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HCPCS Level II Code Updates for July 2024

HCPCS Level II Code Updates for July 2024

The HCPCS Level II quarterly update for July 2024 is now available on the Centers for Medicare & Medicaid Services (CMS) website. The update includes: 134 added codes 9 discontinued codes 32 codes with long description changes 3 codes with payment changes New HCPCS Level II Codes Effective July 1, 2024, there is one new […]
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Telehealth Claims Decline in Q1: Things To Know

Telehealth Claims Decline in Q1: Things To Know

Based on FAIR Health’s Monthly Telehealth Regional Tracker, the national decline in private insurance telehealth claims reached 5.4% in April, comprising 5.3% of all medical claims. This reduction can be observed across all four U.S. census regions: the Midwest (4.7%), Northeast (6.3%), South (6.8%), and West (6.4%). On average, patient visits lasted between 20 and […]
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The State of Claims and Denials in 2023

The State of Claims and Denials in 2023

How do you resolve a repeated and shooting up problem like claims denials? It’s been a fresher subject for revenue cycle management professionals for years that are only experiencing hotter with the growing pressures of staffing shortages, troubles with staff movement and instructing and developing policies and protocols at the government and payer levels. On […]
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Medicare Advantage

Medicare Advantage Dual Eligible’s Have Fewer ER Visits Than Those Under FFS

Dual eligible Medicare Advantage beneficiaries had 42.1% less emergency room visits than their fee-for-service counterparts. The cost of care and rate of hospitalizations for dual eligible Medicare Advantage (MA) beneficiaries was considerably lower than dual eligibles under fee-for-service (FFS), according to an Avalere Health study released Tuesday evening. Dual eligible Medicare Advantage (MA) populations averaged healthcare […]
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