Tagged with Radiology Billing
2022 Radiology Billing: Positive and Negative
Our radiology billing 2022 roundup details positive factors like Low Dose CT screening, PET scans and more. But Medicare rates are a negative
Will Radiology Reimbursement be Slashed in 2022?
2022 Radiology reimbursement continues to be a very hot topic. While there is nothing official to report, there has been an avalanche of lobbying and letter writing including dire predictions for what could happen if the lower radiology billing rates go into effect.
2022 Radiology Billing Changes
2022 Radiology Billing will be affected (mainly cut) by RVU updates, pending cuts in the Medicare Physician Fee Schedule and more.
Radiology Reimbursement Hit by 2022 MPFS Changes
Radiology reimbursement will be hit by proposed MIPS and clinical labor rate changes in the 2022 Medicare Physician Fee Schedule. On top of other changes.
Healthcare Utilization Not Bouncing Back
Recent data throw cold water on expectations that patients will “catch up” on missed treatment, impacting non-COVID physician reimbursement
UnitedHealthcare Implements Enhancements to Procedure to Modifier Policy
UnitedHealthcare has announced plans to implement certain changes to enhance the Procedure to Modifier Policy for Medicare Advantage plans to include modifiers CT, FX and FY.
UHC Radiology Program Procedure Code Changes
Effective January 1, UnitedHealthcare (UHC) will update the procedure code list for the Radiology Notification and Prior Authorization programs based on code changes made by the American Medical Association (AMA). Claims with dates of service on or after January 1 are subject to these changes.
Year-End Spending Bills Include Millions toward Key Radiology Research Efforts
The year-end spending bill package signed, last month, by the president will provide billions in funding toward research that’s key to radiologists’ work. The legislation allocates $41.7 billion to the National Institutes of Health (NIH) and also provides $338 million to the Agency for Healthcare Research and Quality to support NIH research initiatives.
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.
ACR Seeks Urgent Action Opposing Cuts to Radiology
The American College of Radiology (ACR) is seeking help in its efforts to urge Congress to stop CMS from implementing proposed changes to the Evaluation and Management (E/M) Codes that could result in severe cuts to radiology.
Infographic – AdvantEdge Healthcare Solutions – Radiology
AdvantEdge Healthcare Solutions is one of the nation’s best radiology billing, coding, and revenue cycle management vendors for radiology practices across the country. To learn how AdvantEdge can be your billing and coding vendor, call us at 877-501-1611 or email us info@ahsrcmstg.wpengine.com
CMS Advances ‘Patients over Paperwork’ Initiative Under Final Rule
On September 26, CMS issued The Omnibus Burden Reduction (Conditions of Participation) Final Rule, which advances the ‘Patients over Paperwork’ initiative aimed at reducing administrative costs in healthcare.
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.
House Ways and Means Committee Chairman Proposes New Approach to End Surprise Medical Bills
In a letter to the House Ways and Means Committee, Chairman Richard Neal has proposed that the Departments of Health and Human Services (HHS), the U.S. Labor and Treasury Department, along with other interested parties, consolidate their efforts to develop standards for rates for surprise bills.
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 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 are the ones that…
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.
Aetna Wisconsin Issues New Preapproval Requirements for Members
Effective July 1, Aetna will require prior authorization for certain procedures under its Enhanced Clinical Review Program with eviCore healthcare.
Aetna Issues New Radiation Therapy Preapproval Requirements
Beginning July 1, Aetna will require authorization for its enhanced clinical review program with eviCore healthcare for certain outpatient radiation therapy services.
