Transition to value-based reimbursement is essential for Health disparities

Value-based reimbursement inspires clinicians to care for the whole person, who is essential to addressing health disparities confirmed by claims data from the COVID-19 crisis, CMS says. Health disparities confirmed by Medicare claims data for the period of the COVID-19 crisis underscore the need to transition to value-based reimbursement, according to CMS. Health disparities evident in the […]

Quality Payment Program Performance Results

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) enforced CMS to implement an incentive program called the Quality Payment Program as MACRA ended the Sustainable Growth Rate (SGR) formula, which significantly cut payment rates for participating Medicare clinicians. Now, clinicians can choose the following ways to participate in the Quality Payment Program: Merit-based […]

SMALL BUSINESS PAYCHECK PROTECTION PROGRAM

Recently, the president signed the Paycheck Protection Program Flexibility Act of 2020 (HR 7010), since this law does not integrate any kind of additional funding to the Small Business Administration (SBA) Paycheck Protection Program (PPP) loan program. The payment protection program offers small businesses with funds in order to pay up to eight weeks of […]

SEVEN WAYS CODING AND BILLING STRATEGIES CAN IMPROVE YOUR REVENUE

As per the Medical Group Management Association (MGMA) increasing the revenue of the practice rely largely upon filing correct claims which satisfy all reporting guidelines, filing appeals, and tracking denials within the timeline. Apart from this, keeping your business financially healthy is not a simple practice as practices changing from the fee-for-service model to value-based care. […]

Tips to optimize your Revenue Cycle Management (RCM) in 2020

Maintaining smooth operations of a business is a need of an hour. In order to keep your business fiscally healthy optimization of revenue cycle management is an efficient as well as effective way. Providers are likely to suffer from revenue damages from the absence of insurance coverage, improper documentation, medical billing errors, denials of claims, […]

Medicare Increases Payment for High-Production Coronavirus Lab Tests

This announcement made by CMS-Rulings on 14th April 2020. CMS-Rulings provide clarification and interpretation of complex or ambiguous statutory or regulatory provisions relating to Medicare, Medicaid, Utilization and Quality Control Peer Review, private health insurance, and related matters. This Ruling articulates CMS policy concerning the designation and payment of certain clinical diagnostic laboratory tests related […]

Medicare Fee-for-Service (FFS) Billing for COVID-19 Specimen Collection

As part of the Public Health Emergency (PHE) for the COVID-19 pandemic and in an effort to be as expansive as possible within the current authorities to have diagnostic testing available to Medicare beneficiaries who need it, in the interim final rule with comment period, CMS is changing the Medicare Fee-for-Service (FFS) Billing rules during […]

How to increase patient collection in 2020?

As more healthcare bills go to patients themselves, many hospitals and health systems find their existing collections strategies fall short. Traditional solutions are built to collect from insurance companies, not directly from patients. This practice leaves providers exposed to an unpredictable financial landscape where the health of their revenue cycle rests on their patients’ ability […]

Key Role of Coder in Denial Management

Coders are the backbone of an organization’s fiscal health. Timely coding contributes to timely hospital revenue and cash flow, both of which are essential for a hospital to function. However, coders must be willing to look beyond their traditional roles and examine how they can help ensure the continued financial viability and financial success of […]

Basic Tips for Payer Reimbursement Analysis

Reimbursement analysis provides an accurate picture of the reimbursement environment, which is important to ensure your practice will be able to provide new, innovative services. A comprehensive reimbursement analysis should be conducted with adequate lead time to include an in-depth understanding of payer-mix, the delivery cost of the new service, and the anticipated reimbursement by […]

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Revenue Cycle Management (RCM)