Tag: Provider Reimbursement

HHS requests a hold on its surprise billing appeal

After appealing the courts’ ruling on vacating a piece of arbitration within the No Surprises Act, HHS asks the court for a hold on its plea. HHS recently requested for a hold on its appeal of a Texas federal court ruling vacating parts of the independent dispute resolution (IDR) process in the surprise billing interim […]
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Improving Coding Processes to Achieve Value-Based Care Success

Primary care physicians (PCPs) face increasing challenges in the current healthcare environment: not having enough resources to care for patients, declining practice revenues, and overwhelming administrative burdens. On top of all that, there is a necessary, but mounting pressure to shift to value-based care. Having run a cardiothoracic surgery practice for 25 years, I have […]
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“Defensive” Undercoding Is Indefensible

Undercoding, or reporting a lesser service than was performed and documented, is sometimes employed as a defensive strategy to stave off claims denials or audits. But, undercoding can make a provider an outlier, and may create consequential patient care, compliance, and financial liabilities. For example: Undercoding Leaves Money On The Table, Driving Down Provider Reimbursement […]
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