Home Health Care Attendant Care Respite Care
Home Health, Attendant Care, Respite Care Coverage, Coding and Billing Federal Medicare Home Health Care PPS Dates to Balanced Budget Act of 1997 The 1997 Balanced Budget Act (BBA), amended…
Pharmacy Benefit Managers Drug Pricing and Appeals
Pharmacy Benefit Manager Drug Pricing and MAC Appeals - PBM MAC Appeals Pharmacy Benefit Managers drug pricing uses several metrics and Standards. Pharmacy Benefit Managers (PBMs) may use Maximum Allowable…
Integrated Medical Bill Review Risk Management
Integrated Medical Bill Review and Subrogation Integrated medical bill review combines silos into one solution. This article provides a summary of various strategies to determine the value of medical bills. Plaintiffs in…
Coronavirus Federal Regulations for COVID-19
Coronavirus Federal Regulation as of May 5, 2020
Coronavirus Federal Regulation as of May 5, 2020 The Coronavirus Federal Regulation list as of May 5, 2020, is below. COVID-19 has spawned a massive amount of regulations. Strengthening Transparency…
Coronavirus Federal Legislation to address COVID-10
Coronavirus Federal Legislation as of May 5, 2020
Below is a list of coronavirus Federal legislation Coronavirus Federal Legislation continues as the Federal Government prepares to go $3 trillion into debt to fund emergency stimulus measures. As of…
U.S. Leads the World in COVID-19 Testing
World Health Organization and Where the Money Goes
U.S. Led in Contributions but Failed to Receive Commensurate Benefits In the two-year period ending at the close of 2019, the U.S. contributed $893 million to the World Health Organization,…
PracticeFusion designed rules based on patient specific clinical contexts to display advertising to care providers to attempt to influence their choices and received kickbacks
Opinion : Clinical Decision Support is not for Advertising
Practice Fusion Perverted the Intent of Key Patient Safety Measures in Clinical Decision Support in its Electronic Health Record Software According to publicly available sources on the U.S. Department of…
Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update
Medicare Skilled Nursing Facility Billing Changes for 2020
Effective January 1, 2020, with an implementation date of January 6, 2020, the Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing…
New card, new Medicare MBI Standard in 2020
Medicare Beneficiary Identifier Required in 2020
The Medicare Beneficiary Identifier (MBI) is now required for all Medicare transactions. In other words, for medical billing use of the MBI is essential. The Centers for Medicare & Medicaid…
Home Health Patient Driven Groupings
Home Health Patient Driven Groupings The Centers for Medicare and Medicaid (CMS) announced a new Patient-Driven Groupings Model for Home Health that replaces the Prospective Payment System effective January 1,…
Happy Holidays
We wish our clients, family, friends and teammates a happy and safe holiday season
Medicare Future Sounds Like Medicare Past
Forbes published an article on December 11, 2019, after interviewing the Administrator of the Centers for Medicare and Medicaid Services (CMS), Seema Verma. Ms. Verma itemized three focus areas: the lack…