Tagged with Pathology

Some Healthcare Costs Are Going Down. Are yours?

By Joe Laden, Vice President of Client Management Overall healthcare costs have been rising over the years, due to factors such as the aging population and increased use of medical technology. The administration of healthcare reimbursement to providers accounts for a significant portion of healthcare costs, and some of these administrative costs have been decreasing…

CMS, HHS Proposes Changes to Stark Law and Anti-Kickback Statute Reforms

On October 9, the Department of Health and Human Services (HHS) announced proposed changes that seek to modernize and clarify the regulations that interpret the Physician Self-Referral Law (the Stark Law) and the Federal Anti-Kickback Statute. The proposed rule has been designed to provide greater certainty for healthcare providers participating in value-based arrangements and providing coordinated care for patients. The proposed changes are intended to ease the compliance burden for healthcare providers across the industry while maintaining strong safeguards to protect patients and programs from fraud and abuse.

Infographic – AdvantEdge Healthcare Solutions – Pathology

AdvantEdge Healthcare Solutions is a national top 10 medical billing company that is a leading vendor to pathology practices across the country for billing, coding, and revenue cycle management services since 1967.  If you have questions about how AdvantEdge can improve your pathology practice billing and coding so that you are collecting every dollar that…

Texas to Receive Increase in Federal Funds for Uncompensated Care

The Texas Health and Human Services Commission announced, on October 1, that the state will be given $11.6 billion over the next three years to help reimburse health care providers for indigent services and is intended to benefit hospitals, clinics, public ambulance, and dental providers.

Proposed Legislation Aims to Improve Provider Directories Accuracy

Two physician lawmakers have proposed new legislation that aims to improve the accuracy of information in health plan provider directories and protect patients from surprise out-of-network bills. The Improving Provider Directories Act (HR 4575) would require health plans to provide an avenue for people to report errors in provider directories, in a “highly visible way”.

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.

The Healthcare Landscaping is Changing – Billing Services are the Safe Bet

By Brice Voithofer, Senior Vice President of Anesthesia Services & Corporate Accounts Through continuous process improvement (CPI) successful companies constantly re-evaluate their business process to assure they are running their business in the most effective, efficient and innovative manner. Medical practices are no different and must adapt to the ever-changing landscape to survive long-term. Companies that thrive…

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…

CMS Releases 2018 ACA Risk-Adjustment Data

CMS, on June 28, released its report summary of the Affordable Care Act (ACA) risk adjustment program for the 2018 benefit year. The analysis found that 572 health insurers offering ACA plans participated in the program in 2018, and transfers between the companies totaled $10.4 billion.

CMS Issues FAQs on BPCI Advanced Model

CMS, on June 21, issued several new or updated frequently asked questions documents on the Bundled Payments for Care Improvement (BPCI) Advanced Model, an Advanced Alternative Payment Model launched last October that will run through 2023.

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.

New Legislation Aims to Strengthen Stark Law

The Promoting Integrity in Medicare Act (PIMA) seeks to update Medicare policies by preventing self-referrals related to advanced imaging services, radiation therapy, anatomic pathology and physical therapy.

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