As more healthcare bills go to patients themselves, many hospitals and health systems find their existing collections strategies fall short. Traditional solutions are built to collect from insurance companies, not directly from patients. This practice leaves providers exposed to an unpredictable financial landscape where the health of their revenue cycle rests on their patients’ ability […]
Updated on April 6, 2020, as things rapidly develop regarding what we know about COVID-19, telehealth coverage policies have also been developing alongside it. Below is a summary of what is covered by various public and private payers with the information that has been released. Medicare Fee for Service Telehealth Coverage SUBJECT AREA CURRENT POLICY […]
Sykes conducts a survey of 2,000 adults across the U.S. to understand how Americans perceive telehealth today in the era of COVID-19 and how this pandemic impacts how Americans will approach telemedicine in the future. 73% said they would consider using a telehealth service to be screened for COVID-19. More than one in ten respondents […]
A sweeping expansion of telehealth coverage for Medicare beneficiaries is being implemented to aid in the healthcare needs of those with the coronavirus, or COVID-19. The Centers for Medicare & Medicaid Services (CMS) announced in a March 17, 2020, press release that it will make a temporary change in its reimbursement policy for telehealth services. […]
Diagnostic Tests Medicare Part B, which includes a variety of outpatient services, covers medically necessary clinical diagnostic laboratory tests when a doctor or other practitioner orders them. Medically necessary clinical diagnostic laboratory tests are generally not subject to coinsurance or deductible. Medicare Part B also covers medically necessary imaging tests, such as computed tomography (CT) […]
Medicare Advantage plan (also known as “Part C”) is an “all in one” alternative to Original Medicare. Medicare Advantage plans cover Medicare Part A and Part B services, and usually prescription drugs covered under Medicare Part D. These plans also may offer extra benefits Original Medicare doesn’t cover. Medicare Part D also called the Medicare […]
Critical care is the direct delivery by a physician(s) of medical care for a critically ill or injured patient. The care of such patients involves decision making of high complexity to assess, manipulate, and support central nervous system failure, circulatory failure, shock-like conditions, renal, hepatic, metabolic, or respiratory failure, postoperative complications, overwhelming infection, or other […]
Centers for Medicare & Medicaid Services (CMS) took additional actions to ensure America’s patients, healthcare facilities and clinical laboratories are prepared to respond to the 2019-Novel Coronavirus (COVID-19). On 5th March 2020, CMS has developed a second Healthcare Common Procedure Coding System (HCPCS) code that can be used by laboratories to bill for certain COVID-19 […]
For any case of pregnancy in which a woman uses opioids during the pregnancy or postpartum period, codes from subcategory O99.32, Drug use complicating pregnancy, childbirth, and the puerperium, should be assigned. A secondary code from category F11, Opioid-related disorders, should also be assigned to identify the manifestation of Opioid Use and Counseling. Opioid Use […]
Coders are the backbone of an organization’s fiscal health. Timely coding contributes to timely hospital revenue and cash flow, both of which are essential for a hospital to function. However, coders must be willing to look beyond their traditional roles and examine how they can help ensure the continued financial viability and financial success of […]
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