Medisys Compliance

APRIL 26, 2024

office, hospital outpatient department). Common POS codes for primary care include 11: Office; 20: Outpatient hospital. Essential Considerations for Accurate Outpatient Billing Accurate Documentation: Detailed and clear physician documentation is vital for accurate coding.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Patient Satisfaction 59

Kaiser Health News

JULY 20, 2023

Bridget Narsh’s son, Mason, needed urgent help in January 2020, so she was offered the chance to send him to Central Regional Hospital, a state-run mental health facility in Butner, North Carolina. Mason, now 17, was hospitalized for more than 100 days in Central Regional over two separate stays that year, documents show.

Hospitals 55

Hospitals Medical Billing Health Care Reform Health Insurance 55

Medisys Compliance

FEBRUARY 9, 2024

Hospital Outpatient Prospective Payment System (OPPS) Updates OPPS is a payment system used by Medicare to reimburse hospitals for outpatient services, including some wound care procedures. The Centers for Medicare & Medicaid Services (CMS) issues annual updates to the OPPS payment rates and co-payment amounts.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

Healthcare IT Today

AUGUST 6, 2023

News and Research Five in six (83%) of hospitals are collecting SDoH data , according to the latest ONC Data Brief, with 74% using structured, electronic screening tools. Another 60% of hospitals are receiving SDoH data from outside sources, primarily from HIE entities.

Hospitals 80

Hospitals Nurses Medical Billing Ransomware 80

HIT Consultant

JUNE 12, 2022

According to the Journal of the American Medical Association , one in five insured adults had a surprise medical bill from an out-of-network provider. Overall, two-thirds of adults are worried about their ability to afford unexpected medical bills. Surprise Billing Causes. Two-thirds of U.S.

Medical Billing 98

Medical Billing Medicare Medicare Health Insurance 98

Medisys Compliance

MARCH 14, 2023

Wound care is provided in various healthcare settings like inpatient hospital, outpatient clinics, long-term care facilities, home health settings, hospice and skilled nursing facilities. For example, patients who require ongoing wound care but do not need to be hospitalized can receive treatment in outpatient clinics.

Payment Systems 52

Payment Systems Medical Billing Medicare Medicare 52

Medisys Compliance

FEBRUARY 5, 2024

Introduction The healthcare landscape is ever-evolving, and with it, the way medical services are delivered and billed. Ambulatory Surgery Centers (ASCs) have emerged as popular settings for various outpatient procedures, offering convenience and cost-effectiveness compared to traditional hospital stays.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

Medisys Compliance

MAY 23, 2023

Medical billing can be a complex and confusing process for patients, with opaque pricing and unexpected charges often leaving individuals with large bills that they struggle to understand or afford. For patients, understanding medical billing can still be a daunting task, even with the increased transparency provided by the law.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medical Billing Services Hospitals 52

Medisys Compliance

MARCH 26, 2024

However, navigating the complexities of Holter monitor billing can be a time-consuming and error-prone process. Medisys Data Solutions (MDS) , a leading medical billing company, understands these challenges. This guide explains basis of Holter monitor billing, empowering cardiology providers to optimize their revenue cycle.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Governance Medical Billing Services 64

Kaiser Health News

JANUARY 12, 2024

Former Olympic gymnast Mary Lou Retton spoke out last week on the NBC “Today” show about what she said was a rare pneumonia that almost killed her and resulted in an expensive, monthlong hospital stay. For those with very low incomes, the law expanded eligibility for Medicaid, which is a state-federal program.

Health Insurance 133

Health Insurance ACA Medicaid Medicaid 133

Medisys Compliance

MAY 19, 2022

The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. During the COVID-19 public health emergency, any health care provider who is eligible to bill Medicare can bill for telehealth services regardless of where the patient or provider is located.

COVID-19 52

COVID-19 Medicare Medicare Medical Billing 52

Healthcare IT News - Telehealth

DECEMBER 23, 2020

Among the more than 5,500 pages of the coronavirus relief bill passed by Congress this week were a number of provisions aimed at expanding broadband and telehealth services, as well as addressing the needs of rural hospitals. Although the U.S. ON THE RECORD.

Medical Billing 164

Medical Billing Telemedicine Medicare Medicare 164

HIT Consultant

JUNE 16, 2022

The importance of the No Surprises Act (NSA) cannot be overstated, as surprise medical bills have long been burdensome for patients in the U.S. consumers have received an unexpectedly large medical bills. The purpose of the No Surprises Act is to prevent surprise out-of-network bills, often for emergency services.

Medical Billing 52

Medical Billing Compliance Health Insurance Hospitals 52

Medisys Compliance

APRIL 22, 2022

In the Medicare Physician Fee Schedule final rule issued in November 2021, the Centers for Medicare and Medicaid Services (CMS) added four new CPT codes (99424, 99425, 99426, and 99427) in the category of Principal Care Management (PCM) to replace the two previous PCM codes (HCPCS codes G2064 and G2065). PCM Codes Description.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medicare Medicare 52

Medisys Compliance

JUNE 28, 2022

On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule in the Federal Register that addressed the classification and payment of continuous glucose monitors (CGMs) under the Medicare Part B benefit for durable medical equipment (DME). Billing Codes for Continuous Glucose Monitors (CGMs).

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Medicare Medicare 52

Medisys Compliance

MARCH 19, 2024

Additional Billing Considerations In addition to mastering the core billing codes, providers must also navigate supplementary elements integral to accurate billing: Place of Service (POS) Codes: Indicating the treatment setting (e.g., office, hospital outpatient), POS codes play a pivotal role in determining reimbursement rates.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Health Services Administration Public Health 59

Medisys Compliance

APRIL 20, 2022

Medicare won’t cover over-the-counter COVID-19 tests for Medicare Part A (Hospital Insurance) coverage, but beneficiary may be able to get free tests through other programs. People with Medicaid coverage can also get COVID-19 vaccines, including boosters, at no cost. Second COVID-19 Booster Shot at No Cost.

COVID-19 52

COVID-19 COVID-19 Vaccine Medical Billing Medicare 52

Medisys Compliance

JULY 26, 2022

Hospital administrators, physicians, and members of every healthcare office billing department know that if their practice or hospital provides services to Medicare patients, they must be prepared to potentially receive a request for an audit. Medical Office Ready Medicare Audit. Reference: Preparing for a Medicare Audit.

Medicare 59

Medicare Medicare Medical Billing Medical Billing Outsourcing 59

Healthcare IT Today

APRIL 2, 2023

Socially Determined released Redetermination Risk Roster , a product designed to help Medicaid MCOs engage with beneficiaries through eligibility recertification. RPM vendor Health Recovery Solutions formed a Client Advisory Board of hospital systems, hospice care providers, and insurers.

Nurses 80

Nurses Medical Billing Telemedicine Public Health 80

Compliancy Group

FEBRUARY 7, 2024

This is because the Centers for Medicare & Medicaid Services (CMS) have ramped up their efforts to identify organizations that have improperly billed for medical services. The Centers for Medicare and Medicaid Services (CMS) created UPIC audits to identify and stop fraud and abuse in Medicare and Medicaid.

Fraud 52

Fraud Compliance Medicare Medicare 52

Hall Render

MAY 10, 2024

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

AIHC

JANUARY 5, 2022

Starting January 1, 2022, the No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.

Medical Billing 52

Medical Billing Health Insurance Hospitals Medicare 52

Medisys Compliance

AUGUST 4, 2022

The Centers for Medicare & Medicaid Services (CMS) on June 21, 2022, issued a proposed rule that proposes to update payment rates and policies under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to Medicare beneficiaries on or after January 1, 2023. Proposed ESRD Payment System.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Payment Systems Medicare 59

Hall Render

MARCH 15, 2024

NATIONAL 3 things to expect from the pharmaceutical supply chain in 2024 Absence of AI hospital rules worries nurses American Academy of Dermatology votes to keep its diversity policies after anti-DEI proposal Are digital health partnerships replacing M&A? From -6.8%

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Jane Sarashon

FEBRUARY 27, 2024

In addition to highlighting the Patient’s Bill of Rights, NABIP’s keynotes and general sessions will speak to similar topics being brainstormed at VIVE this week — including mental health, maternal health, pharmacy and prescription drugs (pricing, PBMs), population health, and Medicare and Medicaid innovations.

ACA 113

ACA Prescription Drug Pricing Health Insurance Hospitals 113

Hall Render

APRIL 12, 2024

in billing fraud Arizona system names new CEO Banner Health CEO Peter Fine to retire after 24 years, handing the reins to health system president Four UArizona bioscience startups selected for Flinn Foundation program Gov. to Develop Wearable Blood Loss Detector An Academic Lifeline for Rural Hospitals CHI St.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Kaiser Health News

JUNE 16, 2022

Elizabeth Woodruff drained her retirement account and took on three jobs after she and her husband were sued for nearly $10,000 by the New York hospital where his infected leg was amputated. The poll was designed to capture not just bills patients couldn’t afford, but other borrowing used to pay for health care as well.

US Department of Health and Human Services 145

US Department of Health and Human Services Medical Billing Hospitals Medicare 145

HIT Consultant

MARCH 22, 2023

Paul Ketchel, CEO of MDsave Over two years have passed since the hospital price transparency rule was enacted. The Centers for Medicare and Medicaid Services recently announced that in 2021, the nation spent $4.3 A recent study found only 16 percent of hospitals nationwide comply with price transparency guidelines.

Patient Satisfaction 97

Patient Satisfaction Compliance Hospitals Health Insurance 97

Innovaare Compliance

AUGUST 8, 2023

It’s a tool used to help patients know the price of a hospital service or product before receiving it. As of January 1, 2021, every hospital within the U.S. A display of shoppable services that makes it easy for consumers to view the itemized pricing of their hospital visit.

Medical Billing 40

Medical Billing Compliance Hospitals Doctors 40

Healthcare IT Today

OCTOBER 15, 2023

Partnerships Brightside Health is now offering telemental health access to Medicare and Medicaid beneficiaries through partnerships with payers such as Centene, Optum, and various Blues plans. KeyCare is partnering with Remission Medical to provide virtual rheumatology care. Intermountain Health chose ClearSense for data archiving.

Medical Billing 103

Medical Billing Medicaid Medicaid Hospitals 103

Hall Render

APRIL 19, 2024

to Study Treatments for Vascular Abnormalities Federal Appeals Court Hears Arguments on Nation’s First Ban on Gender-affirming Care for Minors Jason Demke Hired as COO at Mercy Hospital Fort Smit Pulaski Tech Awarded $5.7M

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

DECEMBER 22, 2023

Million in Retaliation Suit John Muir, Tenet scrap hospital deal after FTC challenge Kaiser to lay off 79 administrative employees Leaning toward big wins in schizophrenia and vaccines, venture group raises new fund of $389 million Madera hospital creditors want to be paid, including CEO. health care spending hits $4.5

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Kaiser Health News

MAY 31, 2022

So when her primary care doctor suggested she be screened for colorectal cancer in September, Melville dutifully prepped for her colonoscopy and went to New London Hospital’s outpatient department for the zero-cost procedure. Medical Service: A screening colonoscopy, including removal of a benign polyp.

ACA 106

ACA Doctors Medical Billing Hospitals 106

Hall Render

MARCH 1, 2024

in 2023 income Ransomware group leader told hackers to attack hospitals, FBI, HHS say The 23 health systems pushing Congress to act on virtual care Three examples of how AI is going to change medicine U.S. R1 RCM posts $3.3M R1 RCM posts $3.3M R1 RCM posts $3.3M R1 RCM posts $3.3M R1 RCM posts $3.3M R1 RCM posts $3.3M

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses Hospitals 40

Medisys Compliance

FEBRUARY 20, 2022

The service billed incident to must take place in a ‘noninstitutional setting,’ which the Centers for Medicare & Medicaid Services (CMS) defines as ‘all settings other than a hospital or skilled nursing facility.’

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Medicare Medicare 52

Medval Compliance Blog

SEPTEMBER 1, 2021

Historically, hospitals have been reluctant to embrace transparency, arguing that (among other things) disclosing price information would lead to higher costs. The outcome of this EO was the Hospital Price Transparency rule, which after some legal wrangling, became effective January 1, 2021. Responding to Concerns.

Prescription Drug Pricing 52

Prescription Drug Pricing Medicare Medicare Hospitals 52

Medisys Compliance

APRIL 17, 2023

There are several types of insurance plans available including private insurance, Medicare, and Medicaid. Medicare is a federal health insurance program that primarily covers people who are 65 or older, while Medicaid is a joint federal-state program that provides health coverage to low-income individuals and families.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing ADA Medicaid 52