Strategies to Advance Value-Based Care

Health insurers are struggling to get success in an Advance Value-Based Care reimbursement model. This may benefit from population health management, patient engagement, and healthcare delivery reform. When payers started to transition to value-based care reimbursement from the traditional fee-for-service payment system, some healthcare executives and financial experts might find that it takes longer than […]

The Evolution of Interoperability in Healthcare

The evolution of technology has helped it maintain and simplify interoperability and patient data sharing over the last 40 years. The increased number of multiple, implemented IT systems since the early nineties has created an urgent requirement for interoperability in healthcare to help manage the increasing needs of patients. Below are some key drivers for […]

Optimize Patient Payment Collections during Pandemic

Improving your patient payment collection during a pandemic should be your top priority in your financial plan this year. You may think why to focus on patient collection, because with half of the employers pushing high deductibles plans onto workers. Patients are facing bigger medical bills, one they never prepared to pay. If patients deny […]

The BPCI Advanced Clinical Episodes, Prices

CMS is going to make key changes to Bundled Payments for Care Improvement (BPCI) Advanced next year to stop the model from generating financial losses of close to $2 billion over the model’s ten performance periods. Model year 4 will begin on Jan 1, 2021. CMS’s Innovation Center will modify target pricing calculations using an […]

COVID-19 – CPT code 99072

New COVID-19 – CPT code 99072 was established to report additional practice expenses incurred during COVID-19, including supplies and additional clinical staff time. New code 99072 represents a new practice expense code specifically intended for use during a declared PHE as defined by law, due to respiratory-transmitted infectious disease. It accounts for additional supplies, materials, […]

How can your patients prevent Medicare fraud?

Con artists can try to get your patients’ Medicare Numbers or personal information so they can steal their identity and commit Medicare fraud. Medicare fraud results in higher health care costs and taxes for everyone. So, you will have to take care of all HIPAA compliances. Whether you have outsourced medical billing or hired staff […]

Are you in confusion over COVID-19 coding and claim requirements?

According to a new survey that confusion over COVID-19 medical coding and insurance claim requirements is one of the top effects the pandemic has had on revenue cycle management in the healthcare industry. Alpha Health conducted a survey through the Healthcare Financial Management Association’s Pulse program, they inquired 587 chief financial authorities and revenue cycle […]

Impact of Pandemic on Value-Based Contracts

The Healthcare industry is facing implications from the pandemic situations that can impact their ability to improve contract performance and potentially expose them to new risks. Value-based contracts are usually relying on historical data for starting claim targets, trend rates, and/or quality measures. Impact on claims The timing and severity of this pandemic situation is […]

AMA’s CY 2021 CPT Codes Set Release

The American Medical Association (AMA) implemented major changes to the 2021 Current Procedural Terminology (CPT) code set in an effort to streamline coding and documentation of office visits and other outpatient evaluation and management (E/M) services. Streamline E/M Coding These new modifications were designed to make E/M office visit and documentation simpler and more flexible. […]

Advance Beneficiary Notice of Non-coverage (ABN) Updates

Changes to the Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is issued by providers (including independent laboratories, home health agencies, and hospices), physicians, practitioners, and suppliers to Original Medicare (fee for service – FFS) beneficiaries in situations where Medicare payment is expected to be denied. Skilled nursing facilities (SNFs) issue the ABN to transfer […]

We Excel In

We Dominate Over

Our Reach

Insightful Blogs

Interesting Reads

Medical Billing Services