Healthcare News
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Dealing with the negative insurance balance of your practice
11/14/2021
Recently some healthcare providers have reported having a negative balance with certain several insurance carriers they are participating with. Having a negative balance leads to a significant disruption in insurance payments, but it is not the end of the world. There are several ways of "fixing...
Understanding claim timely filing requirements
11/11/2021
Claim timely filing limit is a specific period during which a provider may submit an insurance claim for the rendered services to the payer. In most cases, this period is defined by the number of calendar days since the date when a procedure has been performed. Should a claim be submitted outside of...
Cost-share waiver indication for COVID-19 testing
11/9/2021
Pursuant to regulation by the US Department of Health and Human Services (HHS) on COVID-19 testing cost-share waivers issued on March 13th, 2020, outpatient healthcare providers are required to indicate a cost-share waiver in their claims for services performed on Medicare Part B patients.Namely, th...
A temporary fee-for-service increase for adult Private Duty Nursing (PDN) services by NY Medicaid
11/7/2021
Starting from November 1st, 2021, NYSDOH has increased fees for PDN services for eligible beneficiaries aged 23 or older. This increase is temporary and is planned to be waived on March 31st, 2022. The following services are affected:S9123 - Nursing care, in the home by a registered nurse, per ...
The CMS has authorized coverage for COVID-19 vaccinations for patients aged 5 through 11
11/4/2021
Following a recent FDA approval of the Pfizer-BioNTech COVID-19 vaccine for children 5 through 11 years of age, the CMS has determined that it is now covered for eligible individuals. Namely, individuals insured under Medicare, Medicaid, the Children's Health Insurance Program, as well as under...
An important update by the New York State Workers’ Compensation Board
11/2/2021
The NY State Workers' Compensation Board has ruled out that
effective July 1st, 2022, providers would need to use the CMS-1500 claim
form for medical bills submission. This decision has been made to simplify this
process and relieve providers from a significant portion of the paperwork. ...
ICD-10-CM updates for the Fiscal Year 2022 are out
10/31/2021
Centers for Medicare & Medicaid Services has recently released an updated version of the ICD-10-CM for the fiscal year 2022. An updated set of diagnosis codes came to an effect on October 1st, 2021.The current edition includes 159 additions, 25 deletions, as well as 27 revisions. Here ...
ICD-10-CM updates for the Fiscal Year 2022 are out
10/31/2021
Centers for Medicare & Medicaid Services has recently released an updated version of the ICD-10-CM for the fiscal year 2022. An updated set of diagnosis codes came to an effect on October 1st, 2021.The current edition includes 159 additions, 25 deletions, as well as 27 revisions. Here ...
Getting to know Medicare CBR
10/27/2021
CBR stands for Comparative Billing Report. Medicare CBRs are sent to healthcare providers whose billing or prescribing pattern differs from their peers within the same specialty state- and nationwide. Such reports are aimed at notifying and educating healthcare providers of significant divergence. F...
The CMS has announced Quality Payment Program Updates for 2021
10/25/2021
CMS is determined to lessen the administrative burden
associated with participating in the Merit-based Incentive Payment System
(MIPS) so that healthcare providers can focus on ensuring patients get the best
quality of care.
Thus, the following changes were made for next year an...
COVID-19 Vaccines and Monoclonal Antibodies
5/12/2021
CMS has
released a set of toolkits for providers, states, and insurers to help the
health care system get ready to swiftly administer the COVID-19 vaccines and
certain monoclonal antibodies once they become available. The resources are
designed to increase the number of providers tha...
Medicare Telehealth Frequently Asked Questions
2/28/2021
Medicare issued a waiver for telehealth services for the public health
emergency. But which services are allowed, and who are permitted to furnish
them? Keep reading to find answers to these and many more questions!
Question: What services can be
offered via tele...
HISTORIC CHANGES TO STARK LAW AND ANTI-KICKBACK STATUTE REGULATIONS BY OIG AND CMS.
2/1/2021
CMS has finalized changes to outdated federal
regulations, such as the Stark Law, which have saddled health care providers
with more administrative costs and impeded the advancement of the health care
system toward value-based reimbursement. To know more about these changes and Anti-Kick...
Improving Patient Flow and Growing Health Care Capability with Mind Booster Art
12/9/2020
In health
care settings, fear of uncertainty, preoccupation, and anticipation of
unpleasant sensations create a communication barrier between healthcare
providers and the recipients of services.
Mind Booster Art serves as a form of strategic, non-verbal communication that allevi...
Don’t Be Penalized for COVID-19 Non-Compliance!
11/16/2020
With the
gradual reopening of businesses in New York State, there are guidelines for
businesses that wish to reopen their workplaces. Familiarizing yourself with
these guidelines will help you avoid the accompanying penalties. Keep reading
to find out more about what steps your busin...