Tagged with CMS

Repayment of COVID-19 Accelerated and Advance Payments Underway

If a provider received a COVID-19 accelerated or advance payment, CMS will recoup any outstanding balance from the provider’s Medicare payments. This began March 30, 2021, but generally starts on the one-year anniversary of when the provider received their first accelerated or advanced payment.

CMS has Published the Physician Fee Schedule for 2020. The Time to Get Ready is Now.

By David Nicholson, Executive Vice President CMS has issued its final rule for the 2020 Medicare physician fee schedule, effective January 1. With the added complexity to billing and coding for physicians, how you manage the revenue cycle process for the practice is more important than ever.  For your convenience, I have summarized the major…

CMS Targeted Probe and Educate Audit Program

By Jeanne A. Gilreath, CHBME, Senior Vice President and Chief Compliance Officer One of the many programs CMS has implemented to help providers identify billing issues is the Targeted Probe and Educate (TPE) audit program.   It is designed to identify providers with high denial rates or unusual billing practices according to CMS.  If a provider is…

Laboratory Economics Survey Highlights Increase in Industry Concern around Pathology Reimbursement

By Steve MacCrea, Director of Account Management A recent study by Laboratory Economics (LE) –an independent research and analysis firm focusing on pathology and the laboratory services industry– shows that 82.4% of labs and pathologists cite declining reimbursement as one of the industry’s biggest challenges. During the month of July, LE disseminated it’s Anatomic Pathology & Clinical…