Medicare Advantage (MA) trends continue to show more promising avenues for reimbursement as expansion continues. Coding multiple diagnoses for one[…]
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Medicare Reviews Seniors’ Spine Operations at Surgery Centers
The Medicare program is reviewing whether seniors should undergo spine surgeries conducted same-day at surgery centers. The review will examine[…]
Read moreAppealing Can Eventually Successfully Overcome Claims Denials and GIRS Can Help
Anthem Insurance Companies, Inc., overturned a large number of denied reimbursement claims from patients that have gone to the[…]
Read moreCMS Releases Proposed Changes to Hospital Outpatient Prospective Payment System for 2018
On July 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule (CMS-1678-P) that includes updates to the 2018 rates and quality provisions, and proposes other policy changes. CMS is proposing a number of policies that would support care delivery; reduce burdens for providers, especially in rural areas; lower beneficiary out of pocket drug costs for several drugs; enhance the patient-doctor relationship; and promote flexibility in healthcare. For additional information on this proposal and to comment on it, please contact us at info@girsinc.com.
Read moreUnitedHealth Group to Implement Bundled Payment Models
UnitedHealthcare, a subsidiary of UnitedHealth Group, followed in the Centers for Medicare & Medicaid Services (CMS)’s footstep by recently announcing[…]
Read moreElimination of Medicare Appeals Backlog Ordered by 2020
A federal judge recently decided that the Secretary of Health and Human Services (HHS) must eliminate the Medicare appeals backlog[…]
Read moreCMS Releases Medicare Physician Fee Schedule for Calendar Year 2017. See What is New for Your Accounts…
On November 2, 2016, the Centers for Medicare and Medicaid Services (CMS) released the final Medicare Physician Fee Schedule (MPFS)[…]
Read moreMedicare Sets Goal of 80 Percent Medicare Traditional Payment to Alternate Payment Methods by 2018
Medicare has introduced several alternatives to the traditional payment system such as Accountable Care Organizations, Hospital Value-Based Purchasing, Hospital[…]
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