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Opinion: Is healthcare set to face a pandemic bubble?

In 2020 and early 2021, more than $4 trillion was pumped directly into society, including funding for healthcare providers and facilities. While most Americans spent last year wondering if the world was collapsing, healthcare had one of its best years ever.

2022 Proposed MPFS: See impact to pathology, labs

Pathologists and independent laboratories will experience a handful of significant payment reductions for key services if CMS adopts changes released Tuesday in the 2022 Medicare Physician Fee Schedule (MPFS) Proposed Rule.

Covid Billing

UHC eliminates some OON non-emergency coverage

As part of a new policy update, UnitedHealthcare will no longer cover non-emergency services members receive from out-of-network facilities outside their service area, effective July 1.

HRSA Uninsured Portal gets $4.8 billion boost for Covid-19 testing

On Wednesday, The U.S. Department of Health and Human Services (HHS) announced the agency is directing another $4.8 billion to fund Covid-19 testing for uninsured patients through the Health Resources and Services Administration (HRSA) Uninsured Portal.

CMS eliminating Cost category for 2020 MIPS scoring

Yesterday, CMS announced the agency is not scoring the Cost category for 2020 Merit-based Incentive Payment System (MIPS) participants due to reporting volumes being so heavily affected by the Covid-19 Public Health Emergency and other factors.

HHS offering vaccine reimbursement portal for underinsured patients

Providers who have previously been left footing the bill after administering Covid-19 vaccines to patients whose insurance doesn't cover the shot can now turn to a new reimbursement option being offered by The Department of Health and Human Services (HHS).

A path forward as Cigna ends PC clinical pathology payments

Recently, Cigna announced it will longer going to pay for the professional component of clinical pathology (PCCP) beginning July 11. This comes as no surprise; we have seen this coming for the past few years as UnitedHealthcare, Humana and Aetna have made similar moves.

Image by Jan Vašek from Pixabay

Video: What does the end of Covid-19 look like?

In his latest video, Vachette President Mick Raich looks ahead to what could lead to an end of the current environment of widespread payer coverage for Covid-19 testing and treatment.

CAP offers update on UHC DDP program

Although United Healthcare's Designated Diagnostic Provider Program (DDP) is set to launch July 1, many labs who will be affected by the move to restrict outpatient lab payments for diagnostic services to a select group of in-network providers are still seeking...

Covid vaccine billing FAQ

As the U.S. continues to ramp up its efforts to administer Covid-19 vaccines, many providers have been inquiring about the process for becoming eligible to compliantly bill for vaccines.

With that in mind, the Vachette team has put together a helpful FAQ that covers Medicare payments, how to become a Mass Immunizer, compliant roster billing and more. The full document (PDF) may be downloaded below.

UHC placing ‘pre-pay’ review on some Covid claims

Multiple labs Vachette works with have recently received records requests from UnitedHealthcare to support their Covid-19 testing. While UHC isn't denying these tests for improper coding, the payments they've put on hold amount to nearly $1 million in some instances.

CMS boosts Medicare payment for Covid-19 vaccine administration

CMS announced the Medicare payment for administering Covid-19 vaccines has been increased in an effort by the Biden Administration to expand capacity and vaccinate as many adults as quickly as possible, according to a press issued by CMS today.

Surgical pathologist sought by private practice group

Advanced Diagnostic Pathology Associates, a physician-owned private practice group of four pathologists, is seeking a Surgical Pathologist with strong general pathology skills, the ability to handle high case volumes and excellent communication skills to join their rapidly expanding practice.

CEO update: Examining UHC’s Designated Diagnostic Provider Program and more

In this week's update, Vachette and Stark Medical Auditing CEO Mick Raich reviews UHC’s new Designated Diagnostic Provider Program that will restrict outpatient lab payments for labs who don’t gain entry. He also examines a number of recent audit findings and provides an update of the latest Covid billing issues.

HHS extends Provider Relief Fund reporting deadline, now asking recipients to register

After initially asking providers who received a distribution from the Health and Human Services Provider Relief Fund (PRF) to report on the use of those funds by Feb. 15, HHS is now allowing recipients more time to report due to the ongoing Public Health Emergency (PHE) and changes brought about by the latest COVID relief package.

Image by Jan Vašek from Pixabay

Free Webinar: Strategies for maximizing Covid opportunities in 2021

With the Covid-19 Public Health Emergency now set to stretch into at least mid-April 2021, labs and pathologists working to meet the testing demand must continue to refine their strategies as it becomes increasingly clear this will be a significant line of business throughout 2021.

Covid Billing

2021 Medicare Fee Schedule boost: See impact to pathology services

As part of the COVID relief and and appropriations package signed into effect Dec. 27, Congress took steps to mitigate significant fee schedule reductions for several specialties that were designed to offset payment boosts for evaluation and management (E/M) services.

Career Opening: Medical Billing Auditor

Vachette is seeking a Medical Billing Auditor to join our team! This position will be responsible for reviewing specialty specific reporting to ensure proper coding and billing guidelines are met by clients and billing agencies.

Career Opening: Client Administrator

Vachette is seeking a Client Administrator to join our team! The Client Administrator is the main point of contact with the physician, group, hospital administration, or directors for any of our clients that are being managed.

Who's reviewing revenue strategy with you at this time?

Are you billing all the correct CPT codes? You’d be surprised at what you might be missing. We will review your Fee Schedule/Charge Master at no cost.

That’s right. For free.

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