Tagged with CPT Coding

Executive Order Issued to Protect Traditional Medicare and MA Plans

The president, on October 3, signed an executive order directing the Department of Health and Human Services to increase efforts to provide more insurance plan options under Medicare Advantage and to remove regulations that are considered burdensome to health care providers. The order is intended to protect traditional Medicare and private Medicare Advantage while ramping up alternative payment models, time spent with patients, access to innovative technology and reducing the regulatory burdens on providers.

Data Mining Anesthesia Billing Data for Improved Practice Performance

By Joe Laden, Vice President of Client Management All billing companies and in-house billing operations provide a package of standard reports.   They are generally financial reports designed to report cash flow and illustrate the performance of the billing entity However, data collected for billing can provide a wealth of information for the practice beyond the…

Improper Payment for Intensity-Modulated Radiation Therapy Planning Services

In a recent report, the Office of Inspector General (OIG) determined that payments for outpatient Intensity Modulated Radiation Therapy (IMRT) did not comply with Medicare billing requirements. Specifically, hospitals billed separately for complex stimulations when they were performed as part of IMRT planning. Overpayments occurred because hospitals are unfamiliar with or misinterpreted CMS guidance.

Anthem Announces Fee Schedule Changes

Anthem Blue Cross and Blue Shield (Anthem) recently notified members of the upcoming changes to its Anthem Plan Fee Schedules, scheduled to take place July 1.

CMS Releases 2020 Medicare Advantage and Part D Rates

On April 1, CMS released its finalized payment and policy changes for Medicare Advantage (MA) and Medicare Part D plans for the 2020 coverage year. CMS states the final updates will continue to maximize competition among Medicare Advantage and Part D plans, as well as include important actions to address the nation’s opioid crisis.

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