Healthcare News

Did you know that there are two types of Medicare reimbursement policies?When a Medicare Administrative Contractor makes a ruling as to whether a service or item can be reimbursed, it is known as a local coverage determination (LCD). It is always based on medical necessity and is valid only in the c...

COVID-19 still remains a central topic of discussion among healthcare professionals today. However, there are some other aspects of equal importance that you need to look at in 2022, such as:        The No Surprises Act       New rules of info...

Planning to expand your private practice? If so, you are probably concerned about how to find & accommodate new employees to their positions at your office. When new personnel is employed, many medical practices follow a structured procedure that lasts until the employees are socialized int...

Did you know that 10% of outpatient radiology services are underpaid or denied? According to our internal research, services performed by radiologists are among those for which insurances request medical records most frequently. Why wouldn’t they, considering how complex and costly many i...

Did you know that the CMS conducts various patient satisfaction surveys each year?Most of such surveys are in the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) family of surveys, overseen by the Agency for Healthcare Research and Quality (AHRQ).CAHPS surveys ask patients to r...

Are you a mental health provider planning to enroll with some insurance payers?Did you know that payer enrollment is complicated process that can take up to 180 days to be completed? Moreover, healthcare providers also have to dedicate lots of their time & effort on preparation of each applicati...

Insurance payers want practitioners to be as precise as possible. Did you know that about 10% of claim denials for outpatient office visits occur because providers fail to indicate whether a patient has already visited their office before or not?The CPT guidebook defines a new patient as “one ...

Since the beginning of the COVID-19 pandemic, many insurance payers have lifted or reversed their reimbursement policies. For example, some out-of-network services are temporary payable by various commercial, HMO and Medicare/Medicaid advantage plans. In New York, COVID-19 vaccine administration is ...

With over half a million cases currently reported in the US every day, the COVID-19 pandemic is far from being over. A constant feeling of responsibility mixed with a trivial fear of getting sick from yet another new variant of the virus has encouraged millions of Americans to get a jab.As safe as t...

The COVID-19 pandemic has been ongoing for nearly two years already. With businesses choosing between going fully remote or bankrupt, healthcare providers opt in to perform more telemedicine services than ever. Surprisingly, hospitals are taking the lead. In 2022, treatment cooperation between so-ca...

Are you a psychiatrist treating uninsured or self-pay patients? If so, you are now required to provide a good faith estimate (GFE) of costs of your services to such patients. Pursuant to the No Surprises Act, healthcare providers must reveal an estimate of expected charges for a certain service or a...

Enrolling with an insurance payer is quite a complicated and time-consuming process. Healthcare providers normally have to wait for up to 4 months to become a participating provider with an insurance payer. An insurance panel (or “a payer panel”, “an enrollment ...

  Insurance claims billing and collection is an extremely complicated process. Medical providers and their staff constantly have to make sure that their payer claims are paid by insurance carriers, let alone paid appropriately. While payers rush to make their clinical reimbursement poli...

Insurance claims billing has never been an easy process. However, while it is true that the process of claim filing is quite cumbersome because of a lot of seemingly unnecessary information that you need to specify, it is nevertheless critical. Insurance payers must be aware of all the specific...

Did you know that the US Congress passed the largest spending bill in its history almost 1 year ago?On December 27, 2020, then-President Donald J. Trump signed into law a 5,593 pages-long bipartisan legislation entitled “The Consolidated Appropriations Act, 2021” aimed at distributing CO...