Improving the revenue cycle starts with clean up your medical coding. Codes should have to be right, or the claims your facility or practice submit will be rejected. If claim get rejected mean you don’t get paid on time, and either resubmitting or going through a lengthy appeals process, with no guarantee of full payment
CMS’s Existing Initiatives Protect Medicaid In 2014, CMS revised the Medicaid Provider Reassignment Regulation to provide for a new exception to the direct payment requirement for certain providers, which primarily include independent in-home personal care workers. This new regulatory exception authorized a state to make Medicaid payments to third parties on behalf of certain providers.
The health care costs in the USA are exceeding considerably by 17% of GDP. Whereas expenditure done by other countries are less but with the same time healthcare cost is in increasing trend. As the population ages, the advanced treatments follow and contribute togetherly in increasing the trend of healthcare costs. Also, the insurance companies
The Centers for Medicare & Medicaid Services (CMS) Division of National Standards, on behalf of the Department of Health and Human Services (HHS), have launched the Compliance Review Program. All HIPAA-covered health plans and other entities must comply with Administrative Simplification rules in order to reap the benefits of standardized transactions and reduced administrative costs.
The CMS (Centers for Medicare & Medicaid Services) issued a final rule on May 16, 2019 that modernizes and improves the Medicare Advantage and Part D programs. Now patient will have transparency into the cost of prescription drug in Part D and will also allow Medicare Advantage plans to negotiate better prices for physician-administered medicines
There is a lot of connection between the terms “precision medicine” and “personalized medicine.” According to the National Research Council, “personalized medicine” is an older term with a meaning similar to “precision medicine.” Precision medicine is a method to patient care that allows doctors to select treatments that are most likely to help patients based
Rural hospitals provide essential health care services and are pillars of their communities, but many are struggling to stay open. Rural hospitals are facing challenges due to financial instability and a system that dis-incentivizes visionary transformation. Rural hospitals are essential to their communities as… Provision of vital services to local communities, enabling lower transport times
Patients usually do everything right. They choose an emergency department, a hospital, or an obstetrician in their health plan’s network. Yet they often receive care at some point from an emergency room doctor, anesthesiologist, or another clinician who is an “out of network” provider. Weeks later, a bill arrives asking for the difference between what
According to recent research from public accounting, consulting, and technology firm Crowe, patient access and medical billing and collections are among the top healthcare revenue cycle risk areas for healthcare providers in 2019. Hence, early detection and preparation is the best way to alleviate these risks. The researchers defined a risk area for hospitals, physician
Optometry includes curing vision-related problems, fitting of lenses, diagnosing and treating certain ailments of the eye, sight testing, and correction by the initiation of diagnosis, treatment and the supervision of vision changes. Having its own set of issues with billing and reimbursement, Optometry must focus on receiving the entire payment for treatment provided. The following