Medisys Compliance

APRIL 25, 2024

MACRA replaced the previously used Sustainable Growth Rate (SGR) formula for Medicare physician payments. Advanced Alternative Payment Models (APMs): These models encourage collaboration between providers and offer the potential for higher shared savings if specific quality and cost goals are met.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Medicare Medicare 64

Medisys Compliance

FEBRUARY 9, 2024

Starting in January 2024, home health agencies must bill for dNPWT devices using the dedicated TOB code 032x. This update requires home health agencies to adjust their billing processes and documentation to ensure accurate claims for dNPWT devices. This code is separate from the codes used for other wound care services.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

Medisys Compliance

NOVEMBER 21, 2023

These steps are vital for optimizing SNF billing. Understand Medicare’s Prospective Payment System (PPS) Medicare Part A reimburses SNFs under a PPS, providing a fixed rate per day based on the resident’s classification. Track remaining Medicare Part A SNF benefit days to avoid billing for non-covered days.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicare Medicare Medical Billing 59

Medisys Compliance

MARCH 14, 2023

Wound Care Reimbursements in Various Healthcare Settings Inpatient Hospital Wound care in an inpatient hospital setting is reimbursed through the Diagnosis-Related Group (DRG) payment system. The MPFS is a payment system that reimburses healthcare providers for services rendered to Medicare patients in an outpatient setting.

Payment Systems 52

Payment Systems Medical Billing Medicare Medicare 52

Medisys Compliance

JUNE 16, 2022

If the admitting hospital is a Critical Access Hospitals (CAHs), the payment window policy doesn’t apply. When would the 3-Day (or 1-Day) payment window not apply? We shared basic information on 3-day payment window so when it will be useful while billing outpatients services which later are shifted as inpatients services.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Hospitals Medicare 52