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Impact of Pandemic on Value-Based Contracts

Value-based contracts are usually relying on historical data for starting claim targets, trend rates, and/or quality measures. Current alterations from COVID-19 can disturbing upcoming contract periods for the next one to three years. Additionally, existing risk adjustment models may not appropriately account for COVID-19 pandemic impacts.

AMA’s CY 2021 CPT Codes Set Release

The code set released in the start of September 2020, modified E/M office visit codes 99201 through 99215 will enable physicians to select the code levels based on medical decision-making or total time. These new updates are proposed for adoption by the Centers for Medicare and Medicaid Services on Jan. 1, 2021.

Advance Beneficiary Notice of Non-coverage (ABN) Updates

Changes to the Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is issued by providers (including independent laboratories, home health agencies, and hospices), physicians, practitioners, and suppliers to Original Medicare (fee for service - FFS) beneficiaries in situations where Medicare payment is expected to be denied.

CARDIOLOGY BILLING SERVICES IN KENTUCKY KY

Our Billers in the state of Kentucky are specialized to service medical practices as per the regulations of the state government. Their knowledge and experience has been acquired by years of efforts in perfecting medical billing procedures which they now leverage to help your practice collect more revenue.

Invasive Non-invasive and Interventional Cardiology

Cardiology is a section of medicine where cardiologists are involved in the study, diagnosis, and care of the cardiovascular system. The heart’s function doesn’t have many features so cardiologist has to consider some variables when identifying what goes wrong with a patients’ heart. Some variables are as follows hear, arteries, or blood vessels.

CMS Strategy to fight the Opioid crisis

In 2018, President Trump signed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, or the SUPPORT for Patients and Communities Act, into law, which mobilized Federal efforts to address the nation's ongoing opioid crisis.

CY 2020: Common DME Modifiers

When billing for durable medical equipment (DME), use the appropriate HCPCS code and modifier(s) to describe the items being billed. Also include an ICD-9/ICD-10 diagnosis code indicating the medical condition for which the item has been prescribed.

Outpatient Coding and Inpatient Coding

The hospital coding and billing is truly a complex system, considering the complexity of the hospital environment. Thousands of hospital employees make sure all things are well organized and systematic at the hospital, starting from the patient billing process to the reimbursement process.

Moderate Sedation Coding

Moderate sedation is a part B covered service, with administration by the physician performing the procedure. Moderate sedation is not a hospital outpatient or ASC clinical staff service, so the coding/billing is completed by doctor as a professional fee. It is the physician associated with moderate sedation. The registered nurse under supervision may push the drugs but that person's cost is an element of facility fee.

Targeted Probe and Educate (TPE)

Targeted Probe and Educate (TPE) is the process that a Medicare Administrative Contractor (MAC) can utilize when providers are selected by Medical Review. The TPE review process may include up to three rounds of a prepayment or post-payment probe review with education.

Medicare Shared Savings Program – 2020

CMS is proposing changes to the Medicare Shared Savings Program (Shared Savings Program) quality performance standard and quality reporting requirements for performance years beginning on January 1, 2021, to align with Meaningful Measures, reduce reporting burden and specialize in patient outcomes.

Streamline your DME Billing with MBC

Medical Billers and Coders (MBC) is the leading medical billing service provider that not only help with 70% operational cost reduction but also with the dedicated account manager and robust reporting in line with client protocol. Providing the very best collection rate and productivity metrics.