In the US COVID vaccines are 100% free to all individuals. Only insurance companies or the federal government can be billed for medical reimbursement, not patients. For COVID vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies, and other immunizers will be $40 per dose. If you look […]

Healthcare provider credentialing involves many parties and all basic educational information. Healthcare providers all need to prove their education, skills, and training required to see patients. Simultaneously, healthcare oversight organizations monitor the work of medical providers to evaluate reports of improper care, among other matters. All these reporting and monitoring need to be checked periodically, […]

Confidentiality is a pillar of the healthcare industry. The patients share their private information with physicians hence when deciding how to secure data in the digital age, clinicians must apply professional judgment and follow policies set forth by regulators. Electronic communication of patient information can facilitate clinical care, while mobile technologies and cloud computing boost […]

Spending on healthcare in the US is intensive as health care spending grew 4.6 percent in 2019, reaching $3.8 trillion or $11,582 per person.  As a share of the nation’s Gross Domestic Product, health spending accounted for 17.7 percent. However, an important fraction of this money – up to 10% of total health expenditure is […]

The Centers for Medicare & Medicaid Services (CMS) sets reimbursement rates for Medicare providers and generally pays them according to approved guidelines such as the CMS Physician Fee Schedule. Medicare reimbursement for orthopedic surgery follows the same set of rules; however, recently the amount of Medicare reimbursement for orthopedic trauma surgery has fallen by nearly […]

Effective January 1, 2021, CMS permits Non-Physician Practitioners (NPPs) such as Nurse Practitioners (NPs) and Physician Assistants (PAs) to supervise diagnostic tests (including CIED management) only in states where it is allowed by state law and scope of practice. In all other states, only a physician can supervise diagnostic tests. Previously, CMS permitted non-physician practitioners […]

On Nov. 2, 2020, the American Medical Association (AMA) CPT® Editorial Panel announced the approval of a new Category III CPT® code to describe remote programming of subcutaneous cardiac rhythm monitors. The new code will be effective July 1, 2021. Please note that the existence of a Category III CPT® code does not guarantee payment. […]

Every healthcare provider has a complicated relationship with payers. Healthcare providers are busy in providing treatment to patients and they spend much time with patients and many of the time payers deny payments for the services provided. Providers can prevent claims denials and can ease the denial management that does not come so easy to […]

In a bundled payments model providers and/or healthcare organizations receive a single payment for all the services delivered during an episode of care. When it comes to orthopedics, bundled payments are becoming more sophisticated and standardized with the help of analytic insights based on collected data from the surgeons. CMS has made numerous changes to […]

Are you following an outdated fee schedule for medical practice and missing out on revenue? It is observed that many practices are suffering revenue losses because of their existing fee schedule and not knowing that fact that updating fee schedule for medical practice would improve their bottom line. After reading this blog you can easily […]