Tag: Medical billing company

Reasons for Holdups in the Medical Billing Process

Reasons for Holdups in the Medical Billing Process

The revenue cycle process within healthcare is intricate and has led to disconnections among various stakeholders, including physicians, coding teams, billers, and administrators. This has resulted in the diversion of time and staff resources away from patient care towards revenue collection efforts. This situation leads to lost revenue, diluted patient care quality, and decreased staff […]
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Is Medicare Advantage Really a Disadvantage?

Is Medicare Advantage Really a Disadvantage?

It’s autumn, and along with leaves changing color, pumpkin spice lattes, and cooler weather comes an avalanche of TV ads, commercials, and telephone marketing calls, all entreating us to believe that Medicare Advantage (MA) is the best thing since the invention of the cell phone. With open enrolment season upon us, it’s critical to examine […]
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Billing for Tetanus Vaccine? Check the Diagnosis

Billing for Tetanus Vaccine? Check the Diagnosis

Did you know that tetanus vaccines are covered under Medicare Part B only when administered for treatment purposes? Preventive tetanus vaccinations do not fall under coverage. The Centers for Medicare & Medicaid Services Internet-Only Manuals Pub. 100-02, Chapter 15, Section 50.4.4.2 clarifies, “Vaccinations or inoculations are excluded as immunizations unless they are directly related to […]
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PBMs tend to Dominate State and Local Markets

PBMs tend to Dominate State and Local Markets

Pharmacy benefit managers (PBMs) tend to dominate state and local markets where they provide services to commercial health insurers across the United States. That could mean patients are stuck with higher prescription drug prices, according to new research published by the American Medical Association (AMA). The Policy Research Perspective report, “Competition in Commercial PBM Markets […]
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Intricacies of the 2021 E/M Coding Guidelines

Intricacies of the 2021 E/M Coding Guidelines

Industry experts explain the intricacies of the 2021 E/M coding guidelines. During the Evaluation and Management (E/M) Panel general session, an expert panel made up of a physician, coder, auditor, payer, and a representative from the American Medical Association (AMA) answered audience questions regarding the 2021 E/M coding guidelines for office/outpatient visits. The panelists were […]
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Hospital Expenses Have Increased 23 Percent Since 2016

Hospital Expenses Have Increased 23 Percent Since 2016

Supply chain issues, medication costs, and labor challenges sparked by the COVID-19 pandemic have contributed to the spiking hospital expenses. Hospital expenses have increased 23 percent since 2016, a spike researchers attributed to continuous COVID-19 challenges, according to a recent analysis. By analyzing American Hospital Association data, investigators noticed hospital expenses increased 47 percent in 2020when […]
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Low Reimbursement Rates Lead to Rural Hospital Closures

Low Reimbursement Rates Lead to Rural Hospital Closures

Low reimbursement rates, staffing shortages, low patient volumes, and regulatory barriers are some of the root causes of rural hospital closures, the American Hospital Association (AHA) explains in a new report. The report “Rural Hospital Closures Threaten Access: Solutions to Preserve Care in Local Communities” highlights the variety of causes behind rural hospital closures, which […]
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Flu Vaccination Coding and Billing for 2022-2023

Flu Vaccination Coding and Billing for 2022-2023

Has your billing department prepared for the upcoming 2022-2023 influenza season? As we approach the 2022-2023 influenza season, the Centers for Disease Control and Prevention (CDC) continues to recommend flu vaccination for everyone aged 6 months and older, with the ideal timing being by the end of October. This guidance remains consistent with previous years. […]
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