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 Orthopedic Bundled Payments, these models are becoming more sophisticated and standardized with the help of analytic insights based on collected data from surgeons. CMS has made numerous changes […]
Are you following an outdated fee schedule for medical practice and missing out on revenue?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 […]
The beginning of the Patient Protection and Affordable Care Act resulted in millions of Americans becoming insured on plans with out-of-network benefits. Also, this act has narrowed insurance networks which left many providers completely out-of-network. Therefore, the out-of-network strategy for ASC is only revenue revenue-enhancing strategy for some ASCs. There are some key opportunities available […]
The Office of Inspector General (OIG) recognizes that, in the present public health emergency resultant from the outbreak of the COVID-19, the health care industry must focus on delivering the required treatment to patients. Let’s discuss in more detail about Cost-Sharing Obligations Updates. OIG’s Part in Cost-Sharing Obligations As part of OIG’s mission to encourage […]
Is orthotics the same as orthopedics? If you are looking for an answer then you are at the right place. An orthotic is a device that supports and stabilizes a joint or weakened/injured body part, creating proper alignment, pressure relief, and management of pain while orthopedics is a branch of medicine that focuses on the […]
Cataracts disease of the eye causes the clouding of the lens of the eyeball and removal of these lenses of the eye is called cataract surgery. It is observed that over half of the people in America over age 80 have either had a cataract or cataract surgery hence medical billing for cataract surgery accounts […]
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