Some Medicare payments to hospitals for bariatric surgery may be inappropriate, OIG finds
Medicare could have saved nearly $48 million in bariatric surgery payments to hospitals during an 18-month period if coverage rules and guidance were better implemented at the contractor level, according to the HHS Office of Inspector General.
Revenue Cycle Insights: May 2022
No Surprises Act implementation continues. Though arbitration cases are expected to be addressed in a slow fashion at first, there may be some related regulatory changes that favor providers, Nick Hut reports.
A best-practice approach to coding, coding quality and compliance improves reimbursement
Healthcare providers need to ensure they are accurately paid for the care provided, and that starts with timely, correct and consistent coding. This critical revenue cycle process codifies the clinical care performed and documented.
Medicare coverage updates include revised criteria for lung cancer screening and a code for a newly approved COVID-19 treatment
CMS in February amended its coverage requirements for lung cancer screening and issued a code for a new COVID-19 treatment.
6 ways to ease physicians’ burden from coding, documentation and risk adjustment
The COVID-19 pandemic has heightened the need for U.S. health systems to gain physician cooperation in documenting and coding patient risk. Yet these organizations also should be mindful of the administrative burden many physicians feel from having to perform these processes, which has contributed to feelings of burnout among them. This article describes six steps hospitals and health systems can take to help ease the administrative burden for physicians, which is necessary to ensure the future quality and effectiveness of the nation’s healthcare system.
Medicare’s 2022 payment rule for physician services adds to a significant impending cut
CMS used the 2022 final rule for Medicare physician payments to offer accommodations on policies related to telehealth and more, but concerns loom about a large cut that's in the offing.
How to unleash the true value of your remote reps using workforce management
A data-driven management approach to revenue cycle that empowers your staff could effect sweeping change for improved long-term financial health.
Autonomous coding, it won’t hurt a bit with CodaMetrix
Coding at hospitals and health systems can take hours each day and can cost up to $7 billion in one year. However, one company encourages its use of artificial intelligence technology to reduce both cost and time of coding.
AMA releases 2022 CPT code set with new options that apply to COVID-19 vaccination, digital care services and more
The new set features more than 400 CPT code changes from 2021.
A closer look at the new surprise billing regulations: How cost sharing will be calculated
The qualifying payment amount that establishes a patient's cost sharing for out-of-network care also is intended to factor into negotiations between providers and health plans regarding payment.