Ambulance Transportation CPT Codes and Modifiers

Ambulance transportation services that are covered in Medicare part B covers ground ambulance transportation when a patient needs to be transported to a hospital, critical access hospital, or skilled nursing facility for medically necessary services while the transportation in another vehicle could be hazardous for patient’s health. However, ambulance transportation has certain risks. The risk […]

Key Trends in Value-based Care of Oncology

In the healthcare industry, Value-based healthcare is the new delivery model in which care providers, including hospitals and physicians, are rewarded for helping patients improve their health and are paid based on patient health outcomes. This model has great adoption in Oncology for delivering holistic patient care while driving sustainable cost savings. In this model participating […]

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 […]

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 […]

Impact of Radiology Billing Mistakes on Reimbursement

There are many hurdles during the process of radiology billing reimbursement. Claim rejection and postponements are not only disappointing to your imaging center but also showcase the extended timeline inpatient care, idle machines, and wasted physician hours. From the past few years, imaging centers have observed an increase in prior authorization declinations. Furthermore, in some […]

Coding Updates for Urology in 2020

Multiple coding changes have been made either half-yearly or yearly basis with small reporting to the medical community from Centers for Medicare & Medicaid Services (CMS) as well as other private carriers. Owing to multiple modifications and their extended reporting, billers, and coders, and physicians are unaware of new guidelines until months later when it […]

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