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Tag Archives: Payments
CMS Resurrects Bundled Payments
CMS has said they plan on rolling out mandatory Medicare bundled payment models for cancer, and they are going to reconsider voluntary cardiac care bundled models, even though they had decided that cardiac care bundled care would not work. Bundled Models HHS Secretary Alex Azar indicated that although bundled payments for care is a voluntary […]
The post CMS Resurrects Bundled Payments appeared first on AAPC Knowledge Center.
CMS Discloses Requirements for Positive Payments Under MIPS in 2021
A final rule released for public inspection Nov. 2 finalizes policy for Year 3 (2019/2021) of the Quality Payment Program (QPP). The Centers for Medicare & Medicaid Services (CMS) continues to implement the Merit-based Incentive Payment System (MIPS) and Advanced Alternate Payment Models (APMs), as required by law (i.e., MACRA), while working to reduce the […]
The post CMS Discloses Requirements for Positive Payments Under MIPS in 2021 appeared first on AAPC Knowledge Center.
These 7 readmission risks could prevent you from receiving SNF VBP incentive payments
Medicaid and Medicare Telehealth Payments Fails to Meet Medicare Requirements
OIG reviewed 191,118 Medicare paid distant-site telehealth claims, totaling $ 13.8 million, that did not have corresponding originating-site claims. The watchdog agency then reviewed provider supporting documentation to determine whether the services met Medicare’s requirements for reimbursement. 31% of the telehealth claims did not. Specifically:
24% were unallowable because the beneficiaries received services at nonrural originating sites
7% were billed by ineligible institutional providers
3% were for services provided to beneficiaries at unauthorized originating sites
2% were for services provided by an unallowable means of communication
1% was for a noncovered service
1% was for services provided by a physician located outside the United States
Understand Medicare telehealth requirements—including coverage, coding, and documentation rules—and ensure your telehealth program and claims comply.
Bank on TCI’s all-new, end-to-end Telemedicine & Telehealth Handbook for Medical Practices 2018 to equip you to plan and implement your telehealth services, weigh the cost of care and technology, and master payment aspects, compliance, and other legal requirements.
Our experts take the guesswork out of best practices and government regulations, laying out in-depth information on Medicare and Medicaid reimbursement. Capitalize on insightful answers to readers’ questions. Get the inside scoop on coding, billing, compliance, and everything between to launch your telehealth services without a hitch.
Grow your patient population—and improve outcomes—with a vital telemedicine program:
Master the New 2018 Telemedicine Codes
Navigate the Ins and Outs of Telemedicine and Telehealth
Nail Down Where Telehealth Services Can Take Place
Tackle HIPAA and Compliance Issues for Telemedicine and Telehealth
Get to Know the Basics on Telehealth Reimbursement
Ace Accurate Coding for Telemedicine and Telehealth
Power Up Your Claim Submittals for Services Furnished Via Telehealth
Conquer Inpatient Telehealth Consultations
Lock Down Appropriate Licensure
Are You Eligible for a Geographic Waiver?
Soar to Success with Telemedicine and Telehealth at Your Facility
Gain Tips for Managing the Rapidly Changing Telehealth Technology
Make the Grade with These Consumer-Centered Telehealth Design Principles
Capitalize on New Telemedicine Options from CMS
Get Modifier Updates and Other Expert Documentation Tips
Plus—get easy lookup access to:
Telehealth Services Arranged Alphabetically by Code Descriptor
Telehealth Services Ordered Numerically by Code Number
Glossary of Telemedicine and Telehealth Terminology
And so much more!
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The post Medicaid and Medicare Telehealth Payments Fails to Meet Medicare Requirements appeared first on The Coding Network.
Your Medicare Advantage plan may be inappropriately denying payments
Bundled Payments Reduce Care Cost
Bundled payments seem to be cutting healthcare costs. One of the salient goals of the Affordable Care Act was to bring down the cost of care. As a result, the federal government attempted to assist in reducing the cost of care by implementing a program called Bundled Payments for procedures that are frequently performed […]
AAPC Knowledge Center
OIG Estimates Medicare Improper Payments at $3.7 million
The Office of Inspector General (OIG) reviewed 191,118 Medicare paid distant-site telehealth claims, totaling $ 13.8 million, that lacked corresponding originating-site claims. The watchdog agency then reviewed provider supporting documentation of these claims to determine if the services met Medicare’s requirements for reimbursement. 31% of the telehealth claims did not.
Now is the time to fully understand Medicare telehealth claim requirements and nail down its coding, and documentation rules. Why? Because CMS is planning for a major coverage hike of telehealth services in 2019—as well as a boost in telehealth pay!
Bank on TCI’s all-new, end-to-end Telemedicine & Telehealth Handbook for Medical Practices 2018 to equip you to plan and implement your telehealth services, weigh the cost of care and technology, and master payment aspects, compliance, and other legal requirements.
Our experts take the guesswork out of best practices and government regulations, laying out in-depth information on Medicare and Medicaid reimbursement. Capitalize on insightful answers to readers’ questions. Get the inside scoop on coding, billing, compliance, and everything between to launch your telehealth services without a hitch.
Grow your patient population—and improve outcomes—with a vital telemedicine program:
- Master the New 2019 Telemedicine Codes
- Navigate the Ins and Outs of Telemedicine and Telehealth
- Nail Down Where Telehealth Services Can Take Place
- Tackle HIPAA and Compliance Issues for Telemedicine and Telehealth
- Get to Know the Basics on Telehealth Reimbursement
- Ace Accurate Coding for Telemedicine and Telehealth
- Power Up Your Claim Submittals for Services Furnished Via Telehealth
- Conquer Inpatient Telehealth Consultations
- Lock Down Appropriate Licensure
- Are You Eligible for a Geographic Waiver?
- Soar to Success with Telemedicine and Telehealth at Your Facility
- Gain Tips for Managing the Rapidly Changing Telehealth Technology
- Make the Grade with These Consumer-Centered Telehealth Design Principles
- Capitalize on New Telemedicine Options from CMS
- Get Modifier Updates and Other Expert Documentation Tips
Plus—get easy lookup access to:
- Telehealth Services Arranged Alphabetically by Code Descriptor
- Telehealth Services Ordered Numerically by Code Number
- Glossary of Telemedicine and Telehealth Terminology
- And so much more!
The post OIG Estimates Medicare Improper Payments at $ 3.7 million appeared first on The Coding Network.
OPPS Proposed Rule Puts Site-neutral Payments on the Horizon
The long-awaited 2019 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) proposed rule, released July 25, sets the wheels in motion for significant reforms in the way Medicare will pay providers in hospital outpatient settings. The Centers for Medicare & Medicaid Services (CMS) is moving toward site-neutral payments for clinic visits, which will save […]
AAPC Knowledge Center
2019 Performance Requirements for 2021 Medicare Payments
Medical professionals and other stakeholders have until September 10 to make a difference in the course of future healthcare reforms. Tucked into a proposed rule to update the Medicare Physician Fee Schedule for 2019, released for public inspection on July 12, the Centers for Medicare & Medicaid Services (CMS) proposes policy changes for Year 3 of the Quality Payment Program […]
AAPC Knowledge Center