Three regulatory areas are generating the most immediate compliance and revenue impact for medical practices right now. No Surprises Act billing requirements for out-of-network services, the CMS Physician Fee Schedule updates that adjusted payment rates for dozens of common procedure codes, and Medicare Advantage plan policy changes that affect prior authorization timelines and coverage determinations. […]
CMS Fee Schedule, CMS Fee Updates, Decoding Payment Changes, Medicare Advantage, No Surprises Act
If you’ve ever received a medical bill, chances are you were confused, frustrated, or both. The bills are often filled with inscrutable codes, massive dollar amounts that seem to make no sense, and a complete lack of clarity around what you’re actually being charged. It’s a systemic problem in the US healthcare industry that leads […]
American Hospital Association, Billing, Billing Systemic Reform, Billing Transparency, CMS, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, Medical Billing Transparency, No Surprises Act, Revenue Cycle, Revenue Cycle Management
As US healthcare costs continue rising steeply – now over $4 trillion representing nearly 20% of GDP – both federal and state policymakers urgently seek ways to contain runaway expenditure growth. This drive manifests through expansion of programs like Medicare Advantage and Medicaid managed care coupled with accelerating passage of game-changing legislation like No Surprises […]
Billing, Billing Best Practice, Billing Disruption, Billing Revenue, Claim Data, Consumer-Centered Billing, Good Faith Estimates, Health Level 7, Healthcare, HL7, Interoperability, Medicaid, Medical Billing Regulations, Medicare, No Surprises Act, Pre-Authorization