8 New CPT Codes Added for Bivalent COVID-19 Booster Doses
The American Medical Association (AMA) has announced an editorial update to its Current Procedural Terminology (CPT) code set to include eight new codes for the bivalent COVID-19 vaccine doses from...Value-Based Payment Makes Up Just 6.7% of Primary Care Revenue
The transition to value-based payment is moving at a snail’s pace despite healthcare’s long journey with the transition away from fee-for-service, new survey data indicates. Value-based...CA Healthcare Organizations Settle False Claims Act Violations
A California county organized health system and three healthcare providers have reached a $70.7 million settlement to resolve allegations that they violated the False Claims Act by submitting...CMS Releases Guidance on Independent Dispute Resolution Process
CMS has launched a webpage containing resources and guidance regarding the federal independent dispute resolution (IDR) process under the No Surprises Act. The process helps determine reimbursement...Biden Administration Releases Final Surprise Billing Rules
The Biden Administration has released final surprise billing rules implementing the No Surprises Act, a federal law enacted in January 2021 that protects patients from out-of-network medical bills when...High Out-of-Pocket Costs Led to Low Patient Collection Rates
Patient collection rates at hospitals declined and bad debt increased when out-of-pocket bills reached $7,500, according to a report from Crowe Revenue Cycle Analytics (Crowe RCA). The report reflects...Federal Judge Rejects Surgeon’s Challenge of No Surprises Act
A surgeon from New York has lost a challenge of the No Surprises Act, a federal law enacted earlier this year that bans providers from surprise billing their patients for out-of-network...Key Challenges, Strategies for Patient-First Billing
Patients always come first in healthcare. However, patient-first billing is still a relatively new concept for provider organizations. “Self-pay A/R is really shifting with high-deductible health plans,” explains Adrienne...MGMA Requests Longer Notice Before Surprise Billing Enforcement
The Medical Group Management Association (MGMA) has asked CMS and HHS to provide medical group practices with at least six months’ notice before enforcing any additional surprise billing...Coding Drives Up Medical Billing Costs in the US
Complex coding structures in the US are driving up medical billing costs in the US, making it one of the most expensive countries to get paid, according to a new study. The study published in Health...AMA Announces CPT Code Update for Monkeypox Vaccines, Testing
The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include a laboratory test CPT code for the orthopoxvirus and two CPT codes for the monkeypox...Sponsored by Brault
How Hospitals, EDs Effectively Code Social Determinants of Health
In 2021, the Centers for Medicare & Medicaid Services (CMS) issued guidance to emphasize the importance of social, economic, and environmental factors that can affect the health outcomes of...Pregnancy Care, Childbirth Led to $19K More in Healthcare Costs
Pregnant women enrolled in large group health plans incurred almost $19,000 more in healthcare costs and spent nearly $3,000 more in out-of-pocket expenses than those who did not give birth, a...Sponsored by BridgeMed
