Riding the Silver Tsunami: Demographics Drive Home Health Revolution The term 'Silver Tsunami' is often treated as a distant metaphor, but for the healthcare industry, it is a looming economic…
Medicare Premiums and Social Security: Essential Insights for Retirees by Michael F Arrigo, with prior experience as a member of the Audit Committee of a public company (deemed as a…
Incident-To Billing vs. Direct NPP Billing: In-Network and Out-of-Network Payment Differences and Health Plan Cost Implications (2015–2021) For example, in Medicare, valid incident-to billing allows services by non-physician practitioners (NPPs,…
Medical Billing Expert Witness Insights - Incident to Decision Tree A clear incident to billing decision tree helps healthcare providers determine if services by non-physician practitioners (NPPs, like physician assistants,…
Little-known facts about Medicare Qualifying for Medicare is Not Automatic, and Not All Over-65-Year-Olds Meet the Minimums. Medicare Part B is Not Free, Not Every Type of Medical Care is…
How to Search for Medicare Local Coverage Determinations Medicare Local Coverage Determination (or Medicare LCD) categorizes medical procedures and diagnoses of the patient. In short, claim adjudication systems use business…
Medicare Coverage Requires two Fundamental Things from the Healthcare Provider Medicare requires two things. Medical providers need to ensure that two things are in their medical claims submitted to Medicare…
Medicare Advantage Hospice Carve Ins Medicare Advantage hospice care beneficiaries may enroll into Medicare Advantage (MA) have access to all original Medicare benefits plus additional supplemental benefits beyond what original…
What is Promoting Interoperability? Promoting interoperability was formerly known as "Meaningful Use" under the ARRA HITECH Act of 2009. Promoting interoperability promotes patient engagement and electronic exchange of information using…
Medicare Part D and the Affordable Care Act Medicare Part D first covered Americans in 2005. The Patient Protection and Affordable Care Act (“ACA” or “PPACA”) of 2010 brought noteworthy…
Medicare Local Coverage Determinations for Genetic Testing Medicare Technical Assessment for Molecular Assays To determine coverage for genetic test Medicare LCD, the Centers for Medicare and Medicaid (CMS) requires a…
PAID Act Plus SMART Act Requires NGHPs to Report or Pay Penalties The Medicare, Medicaid and SCHIP Extension Act (MMSEA) of 2007 contains mandatory insurer reporting in Section 111 for…