Medical Billing Services Archives - Page 5 of 13

February 6, 2024
Blog, Medicare Advantage
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Medicare Advantage Rates Face Potential Cut in 2025

MA rates face a potential 0.2% reduction as proposed by CMS. However, analysts said regulators are likely to increase the payout rate in the final announcement. Medicare Advantage health insurers will see a slight decline in their payment MA Rates in 2025 as a new regulatory proposal is finalized. CMS released interim reimbursement rates for […]

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2024 MPFS Final Rule Highlights: Updates for Coding and Billing

2024 MPFS Final Rule: If you don’t have time to read the final medical fee schedule rule, be sure to read this section. Medicare policies may have a significant impact on all payer policies. Therefore, it is important for anyone working with health insurance claims to be aware of policy changes in the New Year. […]

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The Impact of CMS-0057-F on Streamlining Prior Authorization Processes

Interoperability & Prior Authorization Final Rule: Impact on US Healthcare

The healthcare landscape in the United States is poised for a significant transformation with the implementation of the Interoperability and Prior Authorization Final Rule (CMS-0057-F). This landmark rule, finalized by the Centers for Medicare & Medicaid Services (CMS) on January 17, 2024, directly tackles the often-cumbersome prior authorization process, aiming to alleviate administrative complexities for […]

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February 1, 2024
Blog, Medical Coding
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Top Medical Coding Challenges and How to Avoid Them

Medical coding challenges: Medical coding in healthcare is the process of converting complicated medical information into standardized codes that may be used for Medical billing and record keeping. Medical coding presents unique obstacles, even though it is critical for guaranteeing proper compensation and keeping a complete patient history. In this article, we’ll navigate through common […]

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January 31, 2024
Blog, Medical Billing
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Unveiling the Impact of No Surprises Act: AHIP & BCBSA Report

The federal No Surprises Act (NSA) has generated millions of complaints but serves to protect consumers from unexpected out-of-pocket healthcare costs, according to a new survey. AHIP, a U.S. health insurance trade group, and the Blue Cross Blue Shield Association (BCBSA) released a report that estimates the NSA prevents more than 1 million surprise bills […]

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Key Changes In CY 2024 MPFS Final Rule: New E/M Code, Telehealth Updates, And More

The CY 24 MPFS final rule last run the show was disseminated inside the November 16, 2023 Government Select. The run they appear addresses updated installment for specialist and other specialist administrations conjointly sets out unused rulemaking concerning certain other providers and things, such as ambulances, inquiries about offices and other demonstrative offices, and pharmaceutical […]

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January 23, 2024
Blog, Healthcare News, Revenue Cycle Management
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Final Rule for Streamlining Prior Authorization Processes Unveiled

In an effort to streamline prior authorization processes, provider bunches, including the American Medical Association (AMA) and the Medical Group Management Association (MGMA), have asserted that the ultimate goal of the new regulations will assist in facilitating a more efficient and effective prior authorization workflow. Provider bunches are commending CMS for finalizing understanding data-sharing approaches […]

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Updated IDR Processing Fees Post-No Surprises Act Lawsuit

As a result of the most recent provider lawsuit, IDR processing fees have been reworked. Since its inception on Jan. 1, 2022, the No Surprises Act (NSA) has had its growing pains, including four lawsuits challenging the process of Independent Dispute Resolution (IDR). Out-of-network services are paid for with this process when health plans, healthcare […]

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January 10, 2024
Blog, Medical Billing
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Study Reveals Shocking Lack of Medical Billing Quality in US Hospitals

The Healthcare industry 2022 survey found that most hospitals fail to meet new billing measures. There is a shortage of qualified billing representatives at most hospitals, and patient itemized bills are not issued on time. Based on the Healthcare Industry survey’s new measures added in 2022, a study published in Healthcare media examined the quality […]

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New CMS Appeal Process Proposal Expected to Have Low Impact

As a result of their hospital stays that exceeded three days – all of which were outpatient Part B stays – a group of Medicare beneficiaries filed a class action lawsuit in 2010 to recover their costs from stays in skilled nursing facilities (SNFs) for rehabilitation following an illness. It was probably the height of […]

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Tag: Medical Billing Services

Medicare Advantage Rates Face Potential Cut in 2025

2024 MPFS Final Rule Highlights: Updates for Coding and Billing

Interoperability & Prior Authorization Final Rule: Impact on US Healthcare

Top Medical Coding Challenges and How to Avoid Them

Unveiling the Impact of No Surprises Act: AHIP & BCBSA Report

Key Changes In CY 2024 MPFS Final Rule: New E/M Code, Telehealth Updates, And More

Final Rule for Streamlining Prior Authorization Processes Unveiled

Updated IDR Processing Fees Post-No Surprises Act Lawsuit

Study Reveals Shocking Lack of Medical Billing Quality in US Hospitals

New CMS Appeal Process Proposal Expected to Have Low Impact

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