Emergency medicine is facing a host of claims reimbursement updates this year, from looming Medicare payment cuts to new rules about the split and critical care visits. Emergency department providers are still reeling from the effects of the ongoing pandemic. But other important updates are also happening in the background—and they are likely to […]
Effective January 1, 2022, new billing protections went into effect that have the goal of providing greater protections for patients against surprise medical bills. The Departments of Health and Human Services, Labor, and Treasury, and the Office of Personnel Management (collectively, the Departments) implemented these additional protections that are part of the No Surprises Act […]
Don’t send another RHC claim until you’ve reviewed these key changes for 2022. A Rural Health Clinic (RHC) is a clinic located in a rural, underserved area with a shortage of primary care providers, personal health services, or both. Medicare pays RHCs for the provision of certain primary care and preventive health services in […]
This has, in turn, put greater emphasis on the need for Revenue Cycle Management (RCM) systems to enable a healthcare provider to better manage transactions between payer, provider and patients. It can, through the use of various software platforms, boost revenues, reduce denials and enhance the patient experience. According to a survey published by health […]
The complexity around healthcare claims management is a major pain point for provider organizations, big and small. The increasing cost of claims coupled with a complex system of many payers, each with their own rules and requirements, creates administrative burdens and obstacles for providers. Ultimately, this complex system impacts the patient experience, as patients must […]
On December 27, 2020, the No Surprises Act was signed into law as part of the Consolidated Appropriations Act, 2021. In July and October 2021, respectively, the Department of Health and Human Services, the Department of Labor, the Department of the Treasury and the Office of Personnel Management (the Departments) issued two Interim Final […]
Ever since the release of the new 2021 evaluation and management (E/M) guidelines for office and other outpatient services, AAPC has been conducting numerous trainings through webinars, virtual workshops, conference sessions, online courses, and multiple articles in Healthcare Business Monthly and the Knowledge Center blog. In the May issue we started to answer your […]
Hospitals across the nation are seeing lower profits, and it’s all because of a sudden tsunami of Medicare and Medicaid provider audits. Whether it be by Recovery Audit Contractor (RACs), Medicare Administrative Contractors (MACs), Unified Program Integrity Contractors (UPICs), or otherwise, hospital audits are rampant. Billing errors, especially “supposed bundling,” are causing a high rate […]
The number of improper payments made under Medicare fee-for-service declined by $20.72 billion since 2014, according to new figures from the Biden administration. “The continued reduction in Medicare fee-for-service improper payments represents considerable progress toward the Biden-Harris Administration’s goal of protecting CMS programs’ sustainability for future generations. We intend to build on this success […]
CMS attributes the increases in part to rising prices and utilization across the healthcare system, as well as Aduhelm. The standard monthly premium for Medicare Part B enrollees will be $170.10 for 2022, an increase of $21.60 from $148.50 in 2021. This represents a 14.5% increase. The annual deductible for all Medicare Part B beneficiaries […]