Tag: Medicare regulations

Medicare prior authorization exemption

Navigating Medicare’s Prior Authorization Exemption for Hospital Outpatient Departments

The Centers for Medicare & Medicaid Services (CMS) have established a pathway for certain hospital outpatient departments (OPDs) to obtain a temporary exemption from the prior authorization process. This exemption, which lasts for 12 months, is designed to reward providers that consistently demonstrate compliance with Medicare coverage, coding, and payment rules. Understanding how to qualify, […]
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Medical coding and billing challenges

Overcoming Medical Coding & Billing Challenges | Allzone

Medical coding and billing are critical components of the healthcare revenue cycle. They ensure that healthcare providers receive proper reimbursement for the services rendered. However, the ever-evolving regulatory landscape, shifting payer policies, and technological advancements present numerous Medical Coding & Billing Challenges. These challenges significantly impact the efficiency and accuracy of the revenue cycle. As […]
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