The number of uninsured adult Americans rose by around 2.8 percent, or about 7 million people, in the last two years, but perhaps more concerning than the uninsured rate is the nagging feeling about half of Americans have that they are underinsured. And for most, it’s more than a feeling. READ MORE
Billing Anthem for anesthesia services administered during labor and delivery requires physicians to follow specialized guidelines, otherwise the claims will likely be denied. READ MORE
Facility-based physicians and other eligible clinicians whose practice takes place primarily in a hospital setting have a new way to meet reporting requirements for MIPS for the 2019 performance year. READ MORE
The Medicare Payment Advisory Commission may soon be recommending national guidelines for coding emergency department visits after the group discussed options for slowing the growth of emergency department spending during their March meeting. The recommendation would task the Department of Health and Human Services with addressing the shift toward high intensity service levels by 2022. READ MORE
Anthem is once again tweaking policies for modifier 25, apparently still trying to get a handle on separately billed evaluation and management services that are provided on the same day as a minor surgery. READ MORE
Indiana Health Care Programs will no longer reimburse claims that include medical direction by an anesthesiologist of a single anesthesia session with a CRNA or AA, bringing reimbursement in line with existing policy. READ MORE
Ideally, claims submitted to Medicare are always entered and processed correctly and then paid on time according to the Medicare fee schedule. But since we live in the real world, where mistakes can and do happen at any point in the billing process, here are four tips to help you identify and correct billing errors on Medicare claims. READ MORE
A new payment model by the Center for Medicare and Medicaid Innovation (CMMI) hopes to reduce low-acuity hospital visits by allowing ambulance care teams to provide care and transportation based on a patient’s health needs rather than rigid Medicare guidelines. READ MORE
Did you know providers who bill Qualified Medicare Beneficiaries for copays or deductibles could be subject to sanctions by CMS? Learn more about billing for QMBs … including what not to do. READ MORE
Anesthesiologists now have some flexibility when choosing which date to bill Medicare for services that continue into a second calendar day. READ MORE
