Electronic Funds Transfer (EFT) allows Medicare to transfer payments directly to the provider’s financial institution. The Medicare EFT Authorization Agreement (CMS-588) is required for: new provider enrollments; enrolled providers who are not already on EFT; and requesting a change to your existing EFT account information. Most providers find EFT (Electronic Fund Transfer) and ERA (Electronic […]
Most providers face significant challenges when enrolling to receive ERAs (Electronic Remittance Advice) from any Medicare health plan. Some of the challenges include: a wide variety in data elements requested for enrollment; variety in the enrollment processes and approvals to receive the ERA; Absence of critical elements that would address essential questions regarding provider preferences […]
As of January 1, 2020, CMS pays Opioid Treatment Programs (OTPs) through bundled payments for opioid use disorder (OUD) treatment services in an episode of care provided to people with Medicare Part B (Medical Insurance). As of January 1, 2021, Medicare Part B covers hospital outpatient OTP services. All the below-mentioned telecommunication billing updates for […]
Basics of Surprise Medical Billing Out-of-network billing, or ‘surprise medical billing,’ occurs when a patient receives a bill for the difference between the out-of-network provider’s fee and the amount covered by the patient’s health insurance, after co-pays and deductibles. These bills can be unanticipated by patients, who often assume that facility-based providers, including anesthesiologists, are […]
What is EDI Enrollment? For a provider is trying to enroll with Medicare FFS, they must first establish an Electronic Data Interchange (EDI) agreement with Medicare. EDI is the process of using nationally established standards to exchange electronic information between business entities. The Department of Health and Human Services (HHS) adopted certain electronic standards for […]
Documentation is one of the least favorite parts of Emergency Medical Services (EMS) providers’ job. However, next to patient care, it is one of the most important things. Many EMS providers do not appreciate the varied and critical purposes served by their patient care documentation. Some simply see their patient care reports (PCRs) as documents […]
Recently Healthcare Financial Management Association (HFMA) conducted a survey on day-to-day challenges faced by small practice owners. This survey revealed that frontline healthcare workers are not the only ones facing staffing shortages. Registrars, billing specialists, and patient follow-up staff were the most in-demand revenue cycle management positions. The survey gathered responses from more than 400 […]
Unique Medical Billing Operations in the Year 2022 With a considerable number of claims being denied, most medical practices have struggled during the COVID-19 pandemic. Recently, Apollo Healthcare has published its finding on how physicians are coping with the unique challenges of the COVID-19 pandemic. According to the ‘2022 Apollo Healthcare Predictions Report’, US doctors […]
During the Public Health Emergency (PHE), The Centers for Medicare & Medicaid Services (CMS) used a combination of emergency waivers, regulations, and sub-regulatory guidance to offer healthcare providers the flexibility needed to respond to the pandemic. In certain cases, these flexibilities suspended requirements in order to address acute and extraordinary circumstances. Now, CMS is taking […]
The SNF QRP creates SNF quality reporting requirements, as mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). On April 11, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities (SNF) for the year 2023. This […]
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