Fee schedule drift is the gap between when Medicare publishes a payment change and when your charge master and claims reflect it. Practices lose money in that gap without a single denial to show for it. Nothing about this is a staff failure. CMS spreads each change across a fall final rule, a January reset, […]
CMS, Fee Schedule Drift, Medicare Fee Schedule, Revenue Leakage, RVU, Value-Based Adjustments
PECOS, the Provider Enrollment, Chain, and Ownership System, is the CMS web-based portal through which healthcare providers and suppliers enroll in Medicare, update their enrollment information, and manage their participation status. Any provider who wants to bill Medicare for services must have an active, accurate PECOS enrollment record. Billing Medicare without an active enrollment, or […]
CMS, Medicare, Medicare Enrollment, PECOSAfter years of anticipation, CMS has officially launched PECOS 2.0, a ground-up rebuild of how providers enroll in and maintain Medicare participation. This isn’t a cosmetic redesign, it changes daily workflow for anyone who touches Medicare enrollment, credentialing, or revenue cycle operations. Understanding what’s actually different in PECOS 2.0 keeps payments flowing and applications out […]
CMS, Medicare Billing, Medicare Enrollment, PECOS, Revalidation
MACRA changed Medicare reimbursement by ending a model that used to be fairly simple, where you saw the patient, billed Medicare, and got paid based on volume. That model started to shift back in 2015, when Congress passed the Medicare Access and CHIP Reauthorization Act, better known as MACRA. The law rebuilt the way Medicare […]
Advanced APM, CMS, Medicare, MIPS, QPP, Value-Based Models