Out-of-network surprise billing protections through the No Surprises Act have been in place since January 1, 2022, based on several final rules released last year. Now, additional guidance and FAQs have been released, along with an announcement about the impending launch of the online Independent Dispute Resolution (IDR) portal. Here’s a breakdown of recent updates.
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For the past two years, healthcare clinicians and facilities have received financial assistance from the federal government to help cover the costs and losses related to the COVID-19 pandemic. While the nation is still under a public health emergency, the relief funding is beginning to dry up, and providers who miss reporting requirements may be forced to return funds or face consequences. Here is an overview of recent Provider Relief Fund program changes and deadlines. READ MORE
One way to ensure hospital-owned physician practices are maximizing reimbursement is to outsource the billing of professional medical claims to medical billing companies who specialize in physician billing. Such outsourcing offers several key advantages for hospitals, as well as other corporate entities. Here’s why. READ MORE
As of midnight March 22, 2022, providers are no longer able to submit claims to the COVID-19 Uninsured Program for tests and treatment for uninsured patients. Claims for vaccination claims for uninsured patients will stop being accepted at midnight on April 5, 2022.
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Cybersecurity was already one of the top concerns among healthcare organizations at the beginning of 2022, after a record year of healthcare data breaches in 2021. And now, with the ongoing war in Ukraine and the increased international risk of a cyberattack from Russia, its allies, or other bad actors, experts are urging extreme caution and immediate action. READ MORE
A February ruling by Judge Jeremy D. Kernodle in the U.S. District Court for the Eastern District of Texas found portions of the independent dispute resolution process, established by the Departments of Health and Human Services, Labor, and Treasury during last year’s surprise billing rulemaking, to be inconsistent with the No Surprises Act. READ MORE
Payers may deny claim lines with diagnosis codes that lack specificity when it comes to laterality, either because laterality was required and not indicated, or because laterality was indicated as unspecified. In this post, we’ll review ICD-10-CM laterality coding guidelines and offer a few recommendations.
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The CDC is revising their controversial 2016 opioid prescribing guidelines. A draft version was released earlier this month, and public comments are being accepted through April 11, 2022. READ MORE
While bringing on new physicians or other clinicians is an important part of building your medical practice, enrolling them with commercial and government payers can be time consuming…and costly. The tedious process leaves plenty of room for error and delay, both of which can mean missed opportunity for payment. As you work through enrolling providers, here are a few tips to ensure a timely and successful process. READ MORE
With violence in emergency departments on the rise, the American College of Emergency Physicians recently contributed to the development of new workplace violence requirements by The Joint Commission that went into effect for hospitals on January 1, 2022. READ MORE
