Medical Billing

OIG Asks Hospital for $23.6M Back After Medicare Billing Errors

by Jacqueline LaPointe

The Office of the Inspector General has identified $23.6 million in overpayments reimbursed to a Nevada-based hospital, resulting from years of Medicare billing errors. In a report released on April...

Physicians Collect More From Surprise Medical Bills in ED

by Jacqueline LaPointe

Physicians in a hospital’s emergency department (ED) collected significantly more of the charged amount for likely surprise medical bills compared to other patient cases, a new study in Health...

Key Ways Providers Can Prepare for New Surprise Billing Rules

by Jacqueline LaPointe

Starting January 1, 2022, healthcare providers will be subject to a new surprise billing law that makes it illegal for providers to bill patients more than in-network cost-sharing for out-of-network...

Price Transparency to Digital Billing, Unlocking Financial Experience

by Jacqueline LaPointe

Carilion Clinic has had all of its pricing information on its public website since January 1, 2021, the day HHS implemented a new hospital price transparency rule. Compliance with the new...

Hospitals Increasingly Billing Inpatient Stays at Highest Severity

by Jacqueline LaPointe

A new report from the HHS Office of the Inspector General (OIG) has shown that hospitals have increasingly billed inpatient stays at the highest severity level, causing concern about Medicare...

Top Challenges, Opportunities of Medical Coding and Billing

by Jacqueline LaPointe

By April of last year, seemingly every news station in American was featuring the heroic efforts of physicians, nurses, and other clinicians fighting COVID-19. These providers transformed healthcare, implementing telehealth and virtual...

AMA Issues Unique CPT Codes for Janssen COVID-19 Vaccine

by Jacqueline LaPointe

The American Medical Association (AMA) has added new codes to the Current Procedural Terminology (CPT) code set to account for the COVID-19 vaccine candidate from Janssen Pharmaceutica, a division...

Surprise Billing Arbitration Favors Providers, But Rates Are High

by Jacqueline LaPointe

An out-of-network surprise billing solution in New Jersey favors providers, paying them significantly more than in-network prices for the set of services in dispute, according to a new Health Affairs...

KLAS: Epic, MEDITECH Lead Patient Accounting Vendors

by Jacqueline LaPointe

In terms of overall performance, healthcare providers ranked Epic and MEDITECH as the top patient accounting system vendors, according to a recent KLAS report. Patient accounting systems are critical...

AMA Creates CPT Codes for AstraZeneca’s COVID-19 Vaccine

by Jacqueline LaPointe

In anticipation of an emergency use authorization from the Food and Drug Administration (FDA), the American Medical Association (AMA) has created Current Procedural Terminology (CPT) codes for...

Year in Review: Most Read Revenue Cycle Management Stories of 2020

by Jacqueline LaPointe

2020 will go down in history as one of the most challenging years for healthcare providers. From battling a pandemic caused by a novel virus to halting all non-emergent services at the expense of the...

Key Considerations for COVID-19 Vaccine Billing and Coding

by Jacqueline LaPointe

For many providers, the end of the pandemic is in sight with the recent emergency use authorization of a COVID-19 vaccine. And while this may be true, it is just the start of a COVID-19 vaccine billing...

Provider Groups Leery of New Surprise Billing Legislation

by Jacqueline LaPointe

A bipartisan group of Congressmembers has struck a deal over surprise billing protections for patients, but details of the draft legislation have some providers groups concerned about the bill’s...

CMS Provides Billing Codes for Regeneron’s COVID-19 Antibody Drug

by Jacqueline LaPointe

CMS has released Medicare billing codes for a new COVID-19 antibody drug recently approved by the FDA. Healthcare providers are now able to use the Healthcare Common Procedural Coding System (HCPCS)...

New ICD-10 Codes, MS-DRG Assignments for COVID-19 Coming Jan. 1

by Jacqueline LaPointe

Come January 1, 2021, CMS will implement 21 new ICD-10 procedure codes for COVID-19 vaccines and therapeutics for the novel coronavirus, including baricitinib and monoclonal antibody treatments. The...

Medical Billing a Challenge for Struggling Primary Care Practices

by Jacqueline LaPointe

Medical billing is a major challenge for primary care practices already struggling to stay afloat during the COVID-19 pandemic, according to a new survey of nearly 1,500 primary care clinicians. The...

Providers Overhauling Patient Collections Strategies For COVID-19

by Jacqueline LaPointe

The COVID-19 pandemic has had a significant impact on patient collections strategies, according to a new survey from the Healthcare Financial Management Association (HFMA). In the survey of HFMA...

AMA Updates CPT Code Set to Include COVID-19 Vaccine Codes

by Jacqueline LaPointe

The American Medical Association (AMA) has added several COVID-19 vaccine codes to the Current Procedural Terminology (CPT) code set so providers can report immunizations for the novel...

Telehealth Billing Leveled Out in August, But Still Up 3,552%

by Jacqueline LaPointe

Providers are still treating a significant number of patients virtually or by phone, but telehealth billing has plateaued compared to earlier this year, according to updated data from FAIR...

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