Fierce Healthcare

MARCH 21, 2023

CMS ruling paves way for virtual reality companies to obtain reimbursement from payers fdiamond Tue, 03/21/2023 - 15:53

318

318

p3care

OCTOBER 20, 2023

That is, the medical billing companies in USA must be fully aware of reimbursement methods. There are several methods with different reimbursement policies. In this blog, we learn about the reimbursement methods widely implemented in nephrology billing services. Likewise, every method has its coverage and perks.

Medicaid 130

Medicaid Medicare Regulations Healthcare Providers 130

p3care

SEPTEMBER 26, 2023

Therefore, receiving reimbursement for Medicare and Medicare cardiology billing seems difficult. We are here to help you understand the reimbursement principles regarding cardiology billing. How to Maximize the Cardiology Billing Reimbursement? Conversely, we have Medicaid reimbursement for cardiology services.

Medicaid 130

Medicaid Medicare Regulations Prevention 130

Healthcare It News

JANUARY 30, 2023

With the new CPT codes, providers can get reimbursed for: Educating patients on how to use a remote care-management platform. To qualify for reimbursable RTM, providers need to use software deemed a medical device by the FDA. Providers now can get reimbursed for educating patients on how to use remote care management platforms.

Remote Care 229

Remote Care Digital Care Healthcare Providers Integration 229

Health Care Dive

APRIL 11, 2024

Congress has until year-end to take action before some pandemic-era telehealth flexibilities expire, which could create new challenges for patients and providers used to virtual care, witnesses at House hearing said.

233

233

Fierce Healthcare

FEBRUARY 28, 2023

Insurance Companies’ QZ Anesthesia Reimbursement Policies Shifts Costs to Hospitals jpiatt Tue, 02/28/2023 - 12:15

Hospitals 246

Hospitals 246

Health Recovery

APRIL 13, 2023

However, to sustain telehealth programs, healthcare providers require reimbursement for remote patient monitoring (RPM), chronic care management (CCM), and remote therapeutic monitoring (RTM) services.

Remote Care 95

Remote Care Healthcare Providers Healthcare Medicare 95

Fierce Healthcare

APRIL 29, 2024

MultiPlan is in the legal crosshairs of another healthcare system over contracts and services provided to partner health plans that providers have described as collusive and anticompetitive. Allegiance Health Management is the latest provider organization to come out against MultiPlan's out-of-network claim repricing business.

Healthcare 231

Healthcare 231

Fierce Healthcare

OCTOBER 22, 2021

UnitedHealthcare will reimburse providers for COVID-19 vaccine underpayments. Fri, 10/22/2021 - 12:12.

293

293

Healthcare It News

JUNE 5, 2023

However, CareSignal cannot be reimbursed using RPM CPT codes. "Reimbursement is an ongoing question, with some healthcare organizations feeling they can’t rely solely on reimbursement from CPT codes." " Andrea Fox is senior editor of Healthcare IT News.

Integration 185

Integration Secondary Care Accountability Hospitals 185

Fierce Healthcare

NOVEMBER 2, 2021

CMS physician fee schedule rule cuts payments, expands telehealth reimbursement past 2023. Tue, 11/02/2021 - 17:16.

332

332

Fierce Healthcare

SEPTEMBER 30, 2021

VR can help underserved patients, but reimbursement challenges stymie broader adoption, study finds. Thu, 09/30/2021 - 11:14.

339

339

Fierce Healthcare

NOVEMBER 19, 2021

Avalere: Providers face 40% hit to Part B reimbursements under Dem drug price reforms. Fri, 11/19/2021 - 15:04.

337

337

Fierce Healthcare

NOVEMBER 10, 2023

Nearly two-thirds of specialty centers that conduct autism evaluations have wait times longer than four months, according to a new report. Nearly two-thirds of specialty centers that conduct autism evaluations have wait times longer than four months, according to a new report.

301

301

Health Recovery

FEBRUARY 13, 2024

CMS remote patient monitoring reimbursement and telehealth reimbursement can be difficult subjects to navigate. Luckily, our reimbursement team has put together a FAQ to simplify things!

52

52

Health Recovery

APRIL 20, 2023

Welcome to part 2 of our blog series on telehealth reimbursement. In part 1, we discussed the different reimbursement models for telehealth services and addressed some of your burning reimbursement questions.

Medicaid 52

Medicaid Medicare 52

Healthcare ECONOMIST

MARCH 17, 2024

The number of reimbursed prescriptions for each antiobesity medication was identified from public 2011-2022 Medicaid State Drug Utilization data. This is the question asked by Liu et al. They use data from public state Medicaid formulary and preferred drug list files to determine if a state covered FDA-approved anti-obesity medications.

Medicaid 90

Medicaid Pharmaceuticals 90

Health Care Dive

SEPTEMBER 12, 2022

What are the trends in reimbursement and how does it impact future physicians?

246

246

Fierce Healthcare

DECEMBER 19, 2022

OIG calls for tighter scrutiny of providers' Medicare bad debt reimbursement claims. Mon, 12/19/2022 - 16:36.

Medicare 199

Medicare 199

Fierce Healthcare

JANUARY 24, 2022

Senators want Medicare to reimburse at-home COVID-19 tests just like commercial insurers. Mon, 01/24/2022 - 16:20.

Medicare 261

Medicare 261

Fierce Healthcare

AUGUST 24, 2021

New bipartisan bill aims to remove barriers to in-home infusion reimbursements. Tue, 08/24/2021 - 16:59.

261

261

HIT Consultant

DECEMBER 5, 2023

Introducing CVS CostVantage: A New Model for Retail Pharmacy Reimbursement In a significant move, CVS Pharmacy announced CVS CostVantage, a new reimbursement model that aims to bring greater transparency and simplicity to the pharmacy reimbursement system.

Integration 98

Integration 98

Home Health Care

NOVEMBER 20, 2023

For many in the home health industry, constant reimbursement hurdles can be overwhelming. But for small agencies, reimbursement challenges can also be a further push to evolve operations. “I You’re always going to have to face that challenge of not having enough reimbursement to cover your expenses,” Gray said. “So

Home Care 98

Home Care Hospitals Nursing Prevention 98

NASHP

OCTOBER 2, 2023

The table below provides an overview of 18 states’ supportive housing programs under Medicaid, including the Medicaid authority/mechanisms used, the target population(s), in-depth information on included services and service descriptions, and reimbursement approaches for each covered service.

Medicaid 98

Medicaid 98

Fierce Healthcare

JANUARY 21, 2022

KFF: 4 out of 13 major insurers rely on mail and faxes to reimburse at-home COVID-19 tests. Fri, 01/21/2022 - 11:05.

284

284

Healthcare ECONOMIST

JANUARY 24, 2024

The article provides an excellent review of how drugs get reimbursed in the US and who the key players are. These providers receive reimbursement both for the cost of the drug administered and also the professional services rendered to administer this drug. That is the title of a recent paper by Hernandez and Hung (2024).

Medicaid 101

Medicaid Medicare Integration Hospitals 101

Home Health Care

SEPTEMBER 18, 2023

Kristen Trenaman, the VP of public relations and marketing at Help at Home, told Home Health Care News that the state’s reimbursement and regulatory environment has made it tough to recruit, hire and retain caregivers. Medicaid reimbursement for HCBS has generrally gotten much better across the majority of states since the onset of COVID-19.

Home Care 118

Home Care Medicaid Accountability 118

Healthcare ECONOMIST

OCTOBER 11, 2023

My own research shows that there are system-wide effects and that the impact of capitation for primary care physicians on services may depend on whether specialists are also reimbursed via fee-for-service. However, it is not clear how increasing the proportion of reimbursement that is capitated impacts health care service provision.

Medical Services 82

Medical Services General Practice Primary Care Quality of Care 82

Home Health Care

OCTOBER 11, 2023

Amid reimbursement uncertainty in Medicare-certified home health, investors are slowly shifting focus to other home-based care types. Meanwhile, the reimbursement dynamics in HCBS have been mostly positive, Springer said. Reimbursement uncertainty and inflation are real, but will always be there. Labor shortages aren’t new.

Home Care 114

Home Care Medicare Medicaid Healthcare 114

Health Care Dive

JULY 5, 2023

Industry groups argue the payment cuts will exacerbate an already shaky financial situation for home health providers.

242

242

NASHP

MAY 1, 2023

Read the accompanying policy brief : Medicaid Reimbursement for Home Visiting: Findings from a 50-State Analysis. Y/N) Federal Authority and Medicaid Benefit Category Medicaid Covered HV Services Eligibility and Duration of Covered HV Service Medicaid Reimbursement Structure HomVEE Model(s) Required by Medicaid? (Y/N)

Medicaid 98

Medicaid Nursing Prevention Hospitals 98

Fierce Healthcare

JUNE 23, 2023

The Centers for Medicare & Medicaid Services released new details Thursday about how it plans to collect patient data as a condition of coverage for a new class of Alzheimer’s drugs, once the m | CMS released new details Thursday about how it plans to collect patient data as a condition of coverage for a new class of Alzheimer’s drugs, once the (..)

Medicaid 196

Medicaid Medicare 196

Home Health Care

MARCH 29, 2022

At the same time, the home health sector is left out of the telehealth reimbursement picture. The home health benefit itself strictly prohibits agencies’ ability to get reimbursed for telehealth services. Telehealth usage has also slowed, but not so much that providers have gotten any less hungry for reimbursement.

Nursing 144

Nursing Medicare Home Care Medicaid 144

Home Health Care

JUNE 30, 2023

Ross also pointed out that the hospital-at-home space requires advancements in reimbursement mechanisms. Outside of traditional Medicare, health plans are all over the map when it comes to where they land on reimbursing the model. The Boston-based Biofourmis is a technology-focused at-home care enabler.

Hospitals 96

Hospitals Home Care Prevention Medicare 96

HIT Consultant

NOVEMBER 19, 2023

Recognizing this potential shift, insurance providers in 2023 have displayed commendable adaptability, becoming more amenable to discussions, especially around the often contentious topic of reimbursement rates.

Healthcare 98

Healthcare Hospitals 98

HIT Consultant

NOVEMBER 30, 2022

Key Themes and Ideas Regarding Value-Based Care Reimbursement 2022. On the other hand, ACOs and clinically integrated networks, among others, may receive most or all of their revenue from value-based reimbursement, and they represent all organizations in this sample with over 90% of their revenue tied to VBC.

Population Health 98

Population Health Medicaid Medicare Integration 98

Health Recovery

APRIL 26, 2022

Value-based care is quickly emerging as an alternative to traditional fee-for-service models of reimbursement. Designed to drive better patient outcomes, this updated payment model reimburses care provided to patients according to quality rather than quantity.

Prevention 52

Prevention Hospitals Healthcare 52