Incorrect Insurance It is important to ensure all of the correct information is on the claim to prevent delays in payments. Making sure the correct and up to date insurance is obtained can prevent a number of denials and rejections; both of which cause a delay in payment. 1. Is The Plan Active? Verifying eligibility […]
November Bulletin – UnitedHealthcare’s COVID-19 Response – Update
UnitedHealthcare’s COVID-19 Response – Update Telehealth Throughout the public health emergency (currently set to end on January 20, 2021), UHC is extending the cost share waiver for COVID-19 in-network telehealth services. UHC will also waive cost share for COVID-19 treatment until December 31, 2020. For out-of-network services, the cost share for COVID-19 testing […]
First Enforcement Action for Improper Marketing of SARS-CoV-2 Antibody Tests (JUNE 25, 2020)
After initially allowing producers of serologic SARS-CoV-2 antibodies tests free access to the market, the US Food and Drug Administration (FDA) is now cracking down on unproven and inaccurate tests. No More Mr. Nice Guy The turning point came in early May when, in response to heavy criticism and a scathing Congressional investigational report, the […]
Why You Need to Embrace Electronic Medical Records For Your Clinic
The healthcare sector is fast moving towards adopting electronic management of medical records. The move to digital management of records is not only beneficial to the patient but also the healthcare providers. Moving from a manual system of doing things to the digital platform is initially daunting for anyone, but it is worth all the […]
Top Challenges Facing Labs Today: 4 Key Takeaways From Lab Institute 2017
Representatives of Physicians Group Management (PGM Billing) recently returned from attending and exhibiting at Lab Institute 2017. This meeting, hosted by G2 Intelligence, brings together professionals from throughout the lab industry for three days of education and networking. In this ever-changing, ever-evolving healthcare environment, many sessions focused on the top challenges facing laboratories. Here are […]
Clinical Diagnostic Lab Tests Payment System Final Rule: FAQs from CMS
The Centers for Medicare & Medicaid Services (CMS) has published 45 frequently asked questions (FAQs) and CMS responses about the Medicare Clinical Diagnostic Laboratory Tests (CDLTs) payment system final rule. CMS announced on June 17 the release of the final rule, which implemented section 216(a) of the Protecting Access to Medicare Act of 2014 (PAMA). […]
CMS Offers Free Listening Session on Quality Payment Program Proposed Rule
The Centers for Medicare & Medicaid Services’ (CMS) Medicare Learning Network will offer a free listening session the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) The program, titled “MACRA Listening Session: Quality Payment Program Proposed Rule,” is scheduled to take place Tuesday, May 10, from 2:00-3:00 p.m. ET. This listening session is an […]
CMS Announces Plans to Modify Meaningful Use Requirements
In a recent post on The CMS Blog, the Centers for Medicare & Medicaid Services (CMS) announced its intent to update the Medicare and Medicaid electronic health record (EHR) incentive programs beginning in 2015. CMS stated the new rule — expected this spring — will be in response to provider concerns about software implementation, information […]
New -59 Modifier Subsets Go Into Effect
Back in September, we told you about the Centers for Medicare & Medicaid Services establishing new HCPCS modifiers to define specific subsets of the -59 modifier. These new modifiers went into effect on January 1, and had an implementation date of January 5. To summarize: The introduction of the subset modifiers is intended to reduce […]
OIG’s 2015 Planned Areas of Focus Include Ambulatory Surgery Centers, Anesthesia and Chiropractic Services
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Work Plan for Fiscal Year 2015 (pdf) in late October. The Work Plan summarizes planned areas of focus for investigation and enforcement activities that OIG plans to pursue with respect to HHS programs and operations during the current fiscal year […]