COVID-19 has stretched our nation’s healthcare resources to the brink, also having a significant impact on the economic health of medical practices. New challenges because of the pandemic have forced practices and health systems to take a closer look at their financial health. More specifically, providers have been seeking to identify new ways in which […]
Device agnostic digital patient intake; buy now, pay later; compassionate billing; and AI-enabled customizable payment plans are four trends that rev cycle leaders should watch as the pandemic rages on. Despite promises of a “hot-vaxxed summer,” the COVID-19 pandemic is raging on, more forcefully in some places than ever before. It’s also continuing to take […]
In addition to Medicare billing updates, the federal agency also announced that it will resume routine inspections for all Medicare and Medicaid-certified providers. Claims eligible for the 20 percent add-on payment for COVID-19 hospitalizations will now have to have a positive laboratory test documented in the patient’s medical record, according to recent Medicare billing updates […]
The American Medical Association (AMA) has recently expanded its Current Procedural Terminology (CPT) code set to include four additional codes for coronavirus testing. These new codes facilitate providers in reporting a wider range of laboratory tests for the novel coronavirus on medical claims. The newly introduced CPT codes are as follows: •86408: SARS-CoV-2 neutralizing antibody […]
Changes to ICD-10-CM Diagnosis Code mean NCD coding changes. ICD-10-CM Diagnosis Code changes went into effect Oct. 1, as usual, and the Centers for Medicare & Medicaid Services (CMS) is updating National Coverage Determinations (NCDs) to reflect those changes. NCDs Affected by Updates to ICD-10-CM Diagnosis Code CMS notes the following NCD coding changes in […]
There are the standard reasons medical claims are denied, such as putting the wrong modifier on a code or putting the diagnoses in the wrong sequence. But did you know that some reasons are not the fault of medical coding? 5 Ways Your Medical Claim Can Be Denied Denials can be cause by more than an […]
Patients’ appeal a denial are often shocked when their insurance company denies coverage for a procedure or treatment, especially if that leads to a bigger-than-expected bill. These rejections can be fairly common, and people may not put up their best fight to get the decision reversed. Odds are tough, but claim denials can be resolved […]
The focus on electronic health record implementation has turned to how to make use of the vast data stored within to improve revenue cycle operations. “These EHRs capture so much data. The trick is translating that data into information,” said Cynthia Sikina, vice president of Financial Services with consulting firm Afia. The EHR is not providing […]
A frequent knock on electronic health records has been that they’re just glorified billing systems that fail to provide enough clinical functionality to make a significant difference in quality of care. So it’s somewhat incongruous that a recent Black Book report on revenue cycle management (RCM) system adoption would say that 26 percent of hospitals […]
Ending surprise medical bills has risen to a national priority with bipartisan political interest. In January, President Donald Trump directed Cabinet officials to find a solution, and multiple congressional bills were proposed in the last Congress with the same goal. Surprise medical bills consist of unanticipated charges from out-of-network clinicians—often when the facility or primary physician is […]