To understand the role of Artificial Intelligence in Radiology first we need to understand Artificial intelligence (AI): AI and machine learning and it will also be used to develop more clever algorithms that make CAD more intelligent. To achieve this, companies need high-quality data to generate high-quality data output with pathological proof. A data learning […]
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 […]
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 […]
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 […]
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. […]
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 […]
Federal Register announced in their notice that a 1-year extension of the Medicare Prior Authorization Model for Repetitive Scheduled Non-Emergent Ambulance Transport. The extension of this model is applicable in certain states only. Earlier in those states, ambulance suppliers must obtain prior authorization from Medicare before providing scheduled, non-emergency ambulance transportation. These states are: Delaware […]
The COVID-19 pandemic has taken a devastating toll on Americans across the country, whether in lives lost or economic impacts, and it has particularly affected our fellow citizens who have the most vulnerabilities, including the elderly and communities of color. CMS forced us to adjust and adapt our daily lives in innumerable ways, while significant […]
The hospital coding and billing is truly a complex system, considering the complexity of the hospital environment. Thousands of hospital employees make sure all things are well organized and systematic at the hospital, starting from the patient billing process to the reimbursement process. It’s a complex task in itself to make sure the patient billing […]
Targeted Probe and Educate (TPE) is the process that a Medicare Administrative Contractor (MAC) can utilize when providers are selected by Medical Review. The TPE review process may include up to three rounds of a prepayment or post-payment probe review with education. CMS’s Targeted Probe and Educate (TPE) program is designed to help providers and […]
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