Original Medicare Coverage and Payment Related to COVID-19

Diagnostic Tests Medicare Part B, which includes a variety of outpatient services, covers medically necessary clinical diagnostic laboratory tests when a doctor or other practitioner orders them. Medically necessary clinical diagnostic laboratory tests are generally not subject to coinsurance or deductible. Medicare Part B also covers medically necessary imaging tests, such as computed tomography (CT) […]

Medicare Advantage Plan Coverage and Payment Related to COVID-19

Medicare Advantage plan (also known as “Part C”) is an “all in one” alternative to Original Medicare. Medicare Advantage plans cover Medicare Part A and Part B services, and usually prescription drugs covered under Medicare Part D. These plans also may offer extra benefits Original Medicare doesn’t cover. Medicare Part D also called the Medicare […]

Key Takeaways For Physicians From Value-Based Reimbursement

In the rapidly changing healthcare landscape, payers are asking medical providers to shift from volume-based care; the fee for service to a value-based reimbursement structure. This evolution toward value-based reimbursement benefits the patient, the healthcare provider as well as the payers. Value-based reimbursement encourages healthcare providers to deliver the best care at the lowest cost. […]

What Medical Billing Resolutions Should Be Followed For Your Medium – Sized Practice?

It has become imperative in this ever-changing healthcare environment to focus on a medical billing practice’s financial health. In the case of small and medium-sized practices, ancillary services are added, but the best way to increase revenue is by focusing on efficiency. Some Billing Suggestions For Medium-Sized Practices Are: Patient Collections: This must be a […]

The Impact of Financial Incentives on ICD-10 Debate

ICD stands for International Classification of Diseases and its codes hold important information with respect to managing health and treating conditions. The healthcare system in USA relies on a set of codes known as ICD-9 to document diagnosis and in patient procedures. These codes were introduced in the late 1970’s and will be replaced soon […]

Chiropractic revenue model facing billing changes in 2013

Chiropractic as an alternate field of medicine has always suffered the problems of effective billing and revenue management due to lack of priority given to it as a non primary care practice. However, with recent healthcare reforms bringing change in the way Chiropractic is seen in medical circles, an over hauling of revenue models of […]

Utilizing the Medicare Physician Fee Schedule Accurately to Increase Revenue

The Physician Fee Schedule contains valuable information regarding reimbursement and coding for Medicare patients. The Schedule was implemented in January 1992 before which service charges revolved around reasonable and prevailing charges. After the implementation of the schedule, the basis of charging for the services has shifted towards the resource costs that are incurred in providing […]

New Payment Models Transform the Role of Medical Billing

From a long period of time, the healthcare industry has followed the traditional model of payment for claims settlement – fee-for-service model – where specified amount has to be paid for the healthcare service. Recently, the health insurance companies are adopting to new payment models, and they have actively begun considering and testing the new […]

Overcoming the Obstacles Of Transitioning to Value Based Payment Models

The transition to newer payment models is a key issue in the healthcare industry. These reforms are focusing on increasing value, by offering high quality at low costs. We will take a look at few payment models, and then analyze the multiple challenges that the healthcare sector will face during the transition to value based […]

How Will Value Based Payment Models Impact The Medical Billing Process?

Medical billing process is evolving with new healthcare reforms and value based payment models being introduced into the healthcare industry. It is being forecasted that in the next five years, more than half of health plans will be supported by value-based payment models out of which more than 60% are already mid-way through its implementation. […]

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