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Reimbursement

August 26, 2019
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Congress: Advance a Fair Out-of-Network Solution

ASPS Advocacy Summit attendees headed to the Hill in the midst of a heated congressional debate over how to address unanticipated medical expenses. Although all parties are committed to removing patients from billing disputes between providers and carriers, little consensus exists on how to execute that goal. Insurance companies, patient advocacy groups, the physician community, labor unions and others have all been lobbying for their own approaches.

Categories: Reimbursement
August 26, 2019
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One health system’s experience relevant to proposed price transparency rule

CMS recently proposed a rule requiring hospitals to disclose the amount that patients would pay for services before they receive care. The rule is part of the Trump administration’s ongoing effort to lower health care costs and increase transparency.

 

August 26, 2019
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7 Things You Need to Know Now About Appropriate Use and Clinical Decision Support

For physicians who treat Medicare patients, everything changes next New Year’s Day. That’s when real consequences begin to befall those who order advanced imaging—CT, MRI or PET scans—without first consulting appropriate use criteria (AUC). They’ll need to show they did so by using a CMS-qualified clinical decision support mechanism (qCDSM).

Categories: Reimbursement
June 27, 2019
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Why is (almost) no one billing for remote patient monitoring?

Did you know that there are eight CPT codes that could generate potentially millions of dollars of annual revenue for your organization without significantly changing provider workflows — and that would also help you deliver better care? The Centers for Medicare and Medicaid Services’ (CMS) remote patient monitoring (RPM) codes are here: however, very few organizations seem to know about them, and even fewer are taking advantage of them. 

June 27, 2019
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When Medicare Fraud Has Fatal Consequences

Medicare fraud is a victimless crime, right? Unfortunately, some folks still see things that way. That attitude may account for why Medicare fraud costs taxpayers tens of billions of dollars each year. Who says? The FBI! Obviously Medicare fraud isn’t a victimless crime since those Medicare dollars come from taxpayers.

May 30, 2019
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10 Things Radiologists Need to Know About Radiology Extenders

Medicare recently relaxed its rules on the supervision that non-physician radiology providers must have by radiologists for their respective practices to get reimbursed. In the wake of the change, these “midlevel providers” are likely to grow in importance as well as in numbers. And that may be in diagnostic as well as interventional radiology.

Categories: Reimbursement
January 31, 2019
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Providers: Who’s Using Telemedicine Most Frequently?

In recent years, study after study has highlighted the potential that health care organizations, providers, and patients see in utilizing telemedicine. And economists have predicted that the telemedicine market will be worth as much as $40 billion by the year 2021. But despite the sense of excitement surrounding the technologies, from health care organizations’ and providers’ point of view, there are still barriers that are holding back implementation. As one new study shows, providers in some medical specialties are using telemedicine far more than their counterparts in other specialties.

Categories: Reimbursement Trending
January 31, 2019
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Konica Minolta Healthcare Supports CME-Accredited, Ultrasound-Guided Interventional Workshops

Konica Minolta Healthcare Americas, Inc. is providing support to Albert Einstein College of Medicine and the New Jersey Society of Physical Medicine and Rehabilitation for a series of CME-accredited, ultrasound hands-on workshops as part of the UGPLearningHub™ educational platform. Supported by an educational grant and in-kind contribution of ultrasound machines by Konica Minolta Healthcare, participating physicians can receive up to 4 AMA PRA Category 1 Credits™ from Albert Einstein College of Medicine.

October 9, 2018
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Experts discuss potential benefits, disadvantages to Cigna-Express Scripts, CVS-Aetna mergers

The Department of Justice approved the Cigna-Express Scripts merger on Sept. 17, according to Business Insider and The Wall Street Journal reported that the CVS-Aetna merger would likely get the green light by the end of the month. The Department of Justice decisions set into motion many concerns regarding the future of health care, medical and consumer experts told Healio Family Medicine. Many of these experts — most interviewed before the recent Department of Justice actions — said the future of health care looks daunting, not brightening.

September 17, 2018
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CMS proposes cutting more regulations

As part of its Patients Over Paperwork initiative, CMS has proposed another round of “red tape” cuts for healthcare providers that could reduce some burdens and loosen regulations across healthcare settings.

Categories: Reimbursement

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