Outsourcing Billing: Hospital and medical professionals acknowledge that the biggest issue they have are receiving payment for their services. Those in the medical field understand all too well the issue of delayed revenue and dormant collections. Though technology has improved the in-office process, the inadequate handling of the hugely important Medical billing process can lead […]
Due to technological innovation, the healthcare sector faces greater transformation. Adopting new technologies and implementing virtual care brought significant change in Medical Billing. The year 2022 ends with a substantial rise in the adoption of payment systems and the implementation of new technologies in the Medical billing process. In addition, the integration of advanced Medical […]
Appeal rights appear much narrower than many expected. Earlier this year, a federal appeals court issued an opinion on Barrows v. Becerra, a long-running class action lawsuit. Filed by a group of Medicare beneficiaries, the suit alleged they had to pay out of pocket for skilled nursing care—despite being hospitalized for over three days—because their […]
CMS issued a proposed rule to update payment rates and policies under the End-Stage Renal Disease Prospective Payment System for renal dialysis services furnished to Medicare beneficiaries on or after Jan. 1, 2023. Here are four takeaways from the proposed rule: Under the proposed rule, Medicare expects to pay $8.2 billion to approximately 7,800 facilities […]
Observation, outpatient outlier payments, and the Inpatient-only List: Getting it right is not always easy. On this week’s Monitor Mondays we had a robust discussion about Condition Code 44. And on June 9, I will be presenting a webinar on the nebulous concept of “outpatient” service in a bed. Both of these have one thing […]
Q: The providers in our clinic want to start billing e-visits.Can they bill for all the communication between the provider and patient through our online portal? A: As you venture into billing e-visits, on-line visits, digital visits – however you’d like to refer to them – let’s review the required elements for these types of […]
Know the facts for ensuring proper payment of these claims in 2022. New policy for split/shared evaluation and management (E/M) visits (including critical care services and prolonged services) was finalized in the calendar year (CY) 2022 Medicare Physician Fee Schedule (MPFS) final rule. Knowing the new guidelines for billing split/shared visits performed in the facility […]
Through the online price transparency tool, users can view hospital service prices and assess machine-readable file completeness. A healthcare technology company has launched an online price transparency tool that allows consumers to compare hospital costs before seeking care. Turquoise Health’s Price Transparency Scorecard lets consumers find prices by searching for specific services or providers. The […]
Medicare Advantage plans expanded their supplemental benefits offerings in 2022, with more health plans offering special supplemental benefits for the chronically ill (SSBCI), according to an issue brief commissioned by Better Medicare Alliance. Medicare beneficiaries typically join Medicare Advantage plans because of the array of supplemental benefits that the program offers in addition to traditional […]
It’s a well-known fact that the U.S. healthcare system is the most expensive in the world. What may not commonly be as understood is that between 15 to 25 percent of total health care expenditures in the U.S. are attributable to administrative costs, and most of those costs are related to billing activities. With many […]










