Medicare Provider Enrollment Flexibilities during COVID-19

CMS is using its authority under section 1135 of the Social Security Act to offer flexibility with Medicare provider enrollment to support the COVID-19 pandemic national emergency. During the PHE, CMS is allowing physicians and non-physician practitioners to temporarily enroll as Medicare providers using a toll-free hotline provided by their MAC. The numbers are listed […]

Oncology Care Model (OCM) are willing to take on two-sided risk

Oncology practitioners in CMS’s Oncology care model (OCM) are willing to take on two-sided risk, according to the Community Oncology Alliance (COA) survey. The oncology practitioners are confident they can get success in providing quality and cost-effective cancer care as the healthcare system undergoes the shift from fee-for-service to value-based care. Community Oncology Alliance surveyed […]

How to use CPT Codes?

CPT is an expansive and important code set which is published and maintained by the American Medical Association (AMA).CPT and ICD code sets are important for medical billing and coding and every coder should be aware of it. Healthcare providers offer various services such as surgeries, evaluations, and any other medical procedure to patients. These services […]

Improved Patient Care: Medical liability regulatory update

In the US, Medical liability is always criticized due to costly, inefficient, and inconsistent in nature. For many decades, various reform efforts have failed to pass legislation that contains costs, stabilizes liability insurance premiums, and meaningfully promotes patient care and safety. Culture of patient care and safety among healthcare organizations Patient care and safety can […]

Account receivable services in Healthcare

“Account Receivable” (AR) is a widely used term referring to the amount of money that a customer owes to the company. Similarly, in the healthcare industry, AR means the patient’s account balance becomes due for payment within a year. Account receivable services include the management of many reports dealing with insurance, collection analysis, write-offs, bad debt […]

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 […]

Telemedicine reimbursement and healthcare fraud prevention laws

Policymakers of the US quickly took action in this COVID-19 pandemic to relaxed long-standing healthcare regulations which include telemedicine reimbursement and healthcare fraud prevention laws. Moreover, the government and aligned organizations have developed temporary health policies to support the industry’s response to the pandemic. Telemedicine reimbursement policy During this pandemic, most of the practices opt […]

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 […]

Emergency Use Authorization of Medical Products

Recently, the Secretary of the Department of Health and Human Services (HHS) determined, according to section 564 of the Federal Food, Drug and Cosmetic (FD&C) Act, that there is a public health emergency, which has a serious potential to influence the health as well as the national security of citizens of the U.S. staying in other […]

FDA Warns of Newly Discovered Potential Drug Interaction

The United States Food and Drug Administration (FDA) is cautioning health care providers regarding the newly revealed potential drug interaction linked to inspectional antiviral drug remdesivir that has given emergency utilization authorization for the treatment of the COVID-19 patients with serious disease. Revision in the fact sheet According to the recent non-clinical laboratory study, the […]

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