Evaluation and Management (E/M) Coding Based on Time
In 2021 and 2023, time-based E/M service guidelines underwent significant revisions for office/outpatient and inpatient/observation services. The...
Pass-through Reimbursement for Your NAHE Program
Medicare is the largest single funding source for hospitals that provide training for residents and fellows in approved residency programs in...
Why Audit Incident To Services
If your practice utilizes Advanced Practice Providers (APPs), such as nurse practitioners or physician assistants, and you’re billing for their...
New Rural Designation – Rural Emergency Hospital
Hospital survival and closures are unfortunately becoming common news headlines. When closures occur in a rural community, there is usually not...
Price Transparency Data is being used to Form Impressions of your Hospital. Are They Right?
JAMA Network Open recently published a study comparing the pricing of physician-owned hospitals (“POH’s”) to non-POH’s[1].
Medicaid DSH Reductions
Federal law requires that state Medicaid programs make Disproportionate Share Hospital (DSH) payments to hospitals that serve a large number of...
A Roadmap for Success: Opening a New Medical Practice
While opening a new practice is certainly possible, it can feel like it requires superhuman effort. Therefore, opening a new practice doesn’t happen...
The Importance of Critical Access Hospital Interim Medicare Cost Reports
As a cost-based reimbursed provider type, Critical Access Hospitals (CAHs) rely on their Medicare cost report to ensure appropriate reimbursement for...
Critical Access Hospital Reimbursement Myths and Facts
Critical Access Hospitals (CAHs) have a very important and challenging role in providing accessible healthcare to rural Americans. With the COVID...
Volume Decrease Adjustment for MDHs and SCHs
The Volume Decrease Adjustment (VDA) is an important benefit to assist Medicare Dependent Hospitals (MDH) and Sole Community Hospitals (SCH) when...
Telehealth Uncertainty
How is your organization preparing for the impending telehealth changes?
Negotiating Higher Payment Rates
When negotiating insurance payment participation agreements with a healthcare provider, it's essential to ensure that you're receiving adequate...