On Aug. 15, 1935, Will Rogers died in a plane crash near Point Barrow, Alaska. He is an Oklahoma legend and one of the best political satirists and commentators ever. I often wonder what his commentary would be on the state of U.S. politics in 2019. As an aside, Oklahoma City has two airports named […]
CMS recently proposed Merit-Based Incentive Payment System changes in 2020 and beyond, including a new participation framework and higher performance thresholds. CMS is planning to overhaul reporting for the Merit-Based Incentive Payment System (MIPS) in order to make the pay-for-performance program less burdensome and more meaningful to providers, according a recently proposed rule. As reported last week, […]
The agency dropped proposals for three key payment programs aimed at cutting administrative burden and boosting price transparency. CMS has released three new proposed payment programs that aim to reduce administrative burden, put patients over paperwork, and increase price transparency for patients, the agency said in a statement emailed to journalists. Specifically, CMS has proposed […]
July is a busy month for medical coders and billers because so many CPT and HCPCS Level II codes changes are implemented July 1. It’s hard to keep track of all the changes, but it’s essential that you do to ensure your coding/billing is correct. Here are several coding and policy updates you will need […]
Medicare Advantage Plan contracts are “take-it-or-leave-it” agreements Many questions are swirling about regarding Medicare Advantage Plan (MAP) denials asking what to do about the increasing number and given reasons. I’ve heard or read some amazing stories where payers have gone to astounding lengths to deny claims. Answers are also swirling about based on understandings of […]
In Part One of this two-part article exploring the implications of MACRA for healthcare providers, healthcare leaders and health IT experts discuss why it’s critical for clinicians to think strategically, rather than tactically, about MACRA compliance. Numerous industry surveys have highlighted that U.S. physicians, by and large, remain unprepared for managing and executing Medicare Access […]
To protect the privacy of Medicare recipients and prevent fraudulent use of Social Security Numbers (SSN), a new, unique 11-character Medicare Beneficiary Identifier (MBI) is replacing the SSN-based Health Insurance Claim Number (HICN) for Medicare transactions such as billing, eligibility status, and claim submissions. The MBI does not change Medicare benefits. What’s Behind The Change? The […]
Q: Are there any updates on the Evaluation and Management code requirements? A: The American Medical Association (AMA) has now weighed in with their E/M coding requirement modifications, which means that all payers will be affected in 2021. If you remember, Medicare announced plans to revamp the E/M coding structure in 2018 and was met with […]
Healthcare is a top priority for American voters and there aren’t dramatic differences by ideology, according to a new survey. Key Takeaways Thirty six percent of Americans ranked healthcare as the most important policy issue facing the nation’s future. Seventy two percent of Americans responded that they were satisfied with the healthcare they received while […]
Proposed rules also include new payment models. The Centers for Medicare & Medicaid Services (CMS) has been quite busy these last few weeks issuing the proposed payment rules for 2020 and making some other announcements. Here is an update on other regulatory activities of interest. On April 22, 2019, the CMS Innovation Center announced the […]