We all received some good news in the early hours of 2013. On January 1, 2013, Congress approved legislation that prevents the scheduled SGR and sequestration cuts to the Medicare fee schedule. The 26.5% SGR cut has been delayed until early March, when the legislation will be reviewed again. Congress approved a one-year freeze in […]
Cliff Averted: Medicare Fee Schedule Intact Read More »
On December 19, 2012, CMS distributed the following message to healthcare providers accepting Medicare: Attention Health Professionals: Information Regarding the 2013 Medicare Physician Fee Schedule The negative update of 27% under current law for the 2013 Medicare Physician Fee Schedule is scheduled to take effect on January 1, 2013. Medicare Physician Fee Schedule claims for
A message from the CMS for Health Professionals: SGR 2013 Read More »
The Affordable Care Act (ACA) requires each state to have a health insurance exchange through which low and moderate-income individuals can purchase private health coverage at subsidized rates. In line with the mandate that each individual have health insurance by 2014, the exchanges are likewise required to be fully operational in each state by January
Status Update: Where Each State Stands with Health Insurance Exchanges Read More »
Earlier this year, the Department of Health and Human Services announced its proposed rule to implement the Affordable Care Act provision that Medicaid reimburse primary care providers at the same rate as Medicare. On November 1, 2012, CMS issued a final rule to implement this increased payment for calendar years 2013 and 2014. Effective January
CMS Final Rule: Increased Medicaid Payment Rates for Primary Care Read More »
The news that so many local healthcare providers and Maryland medical billing companies have long awaited: Carefirst now allows for the electronic submission of Medicare secondary claims! This is a huge time and money saver when handling those secondary claims that did not automatically crossover from Medicare to Carefirst. This change actually became effective back
NO! While the practice of routinely waiving a patient’s co-pay or balance may seem like a harmless favor, it actually can be a violation of a provider’s contract with insurance companies. Several of our clients have asked us directly if it is OK to accept insurance payments and then make a courtesy adjustment on the
Is it OK for healthcare providers to routinely waive patient co-pays and co-insurance? Read More »
Here we are in the midst of flu season — is your healthcare team current with the coverage, coding, billing, and reimbursement guidelines for seasonal flu vaccinations? If you need to brush up, the Centers for Medicare and Medicaid Services (CMS) recently published a helpful compilation of resources on vaccination billing for the 2012-2013 flu
Billing Flu Vaccinations – Resources from CMS Read More »
It has come to our attention that several commercial insurance carriers have been sending providers a letter that notifies them of an upcoming change to their fee schedule. We encourage healthcare providers and billing companies to carefully review the mail that they receive and pay attention to any correspondence from insurance carriers that discusses a
On Friday, August 24, 2012, it was announced by HHS Secretary Kathleen Sebelius that the new compliance date for ICD-10 is October 1, 2014. This announcement comes after HHS announced in April 2012 that the original October 1, 2013 deadline would be pushed back, but no final replacement date had been established until today. The final rule will
Medical Billing Newsflash: CMS Finalizes ICD-10 Date 10.14.2012 Read More »
Yesterday, August 23, 2012, it was announced that the Centers for Medicare & Medicaid Services (CMS) released the final rule for Stage 2 of the Medicare Electronic Health Record (EHR) Meaningful Use Incentive Programs. U.S. Secretary Sebelius states, “The changes we are announcing today will lead to more coordination of patient care, reduced medical errors,
CMS Released the Final Rule for Stage 2 Meaningful Use Read More »
