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Initial steps for complying with the No Suprises Act
went into effect Jan. 1, 2022, the law is still facing a number of legal challenges from provider groups unhappy with the payment dispute resolution process, to say nothing surrounding the uncertainty of its implementation
Will insurers pay for at-home COVID testing?
The concept is simple: you get an at-home COVID test, pay for it, take the test, and then send in the cost to your insurance plan for reimbursement. This is exactly what healthcare used to be.
Medicare cuts, PAMA reporting suspended until 2023 under new legislation
Congress has acted to suspend scheduled Medicare cuts in order to provide financial relief to hospitals and providers amid the COVID-19 Public Health Emergency.
Cigna clarifies new PC/CP policy in letter to CAP
Pathologists providing the professional component of clinical pathology (PC of CP) services now have additional clarity on how to request reimbursement under Cigna's new PC of CP policy after the insurer recently provided more details on the policy in a letter to the College of American Pathologists (CAP).
Automatic 2021 MIPS exemptions granted by CMS
Earlier this month, CMS announced individual clinicians required to report Merit-based Incentive Payment System data in the 2021 performance year will be granted an automatic exemption due to the ongoing COVID-19 Public Health Emergency (PHE).
HHS withdraws policy for LDTs to bolster Covid test review
The policy directed FDA not to enforce premarket review requirements for LDTs. HHS said this move will help to ensure Covid tests are more reliable.
Inflation Medicare cuts and the pinch point of community pathology revenue
I believe the revenue world of pathology is currently in a pinch point, an area of extreme danger which will change the industry going forward.
2022 Final Medicare Fee Schedule: See impact to pathology
One year after Congress delayed planned fee schedule cuts due to the Covid-19 pandemic, it appears pathologists and other specialists are now going to experience payment reductions designed to offset boosts for evaluation and management (E/M) services in 2022, according to the Medicare Physician Fee Schedule (MPFS) Final Rule released Tuesday.
2022 CPT updates for pathology consults
The following are 2022 Current Procedural Terminology (CPT) coding updates for pathology consultations.
Laboratory revenue cycle management in a non-post-pandemic world
I heard the phrase “post pandemic” this week and thought to myself, “Are we ever going to be in a post-pandemic state, or has the world changed?” As I have said all along, things seen cannot be unseen. I think we are going to be living in a Covid world going forward.
Waiting for the magic pill of Covid treatment
I like to look at health care like my old computer. There is a software side and a hardware side. The software to me, is the vaccines, drugs and treatments of a disease. The hardware is the tests and diagnostic tools.
2022 Covid-19 coding updates and revisions
The following updates and revisions for Covid-19-related codes became effective Oct. 1, 2021:
Cigna again moves to end PC clinical pathology payments
After holding off on the move during the summer amid significant pushback from pathology and lab advocates, Cigna appears to again be moving forward with its plan to end reimbursement for the professional component of clinical pathology (PC/CP) beginning Nov. 1, 2021.
Aetna to reduce timely filing limits for non-par providers in 2022
Aetna has announced timely filing limits for non-participating providers will be reduced from 27 months to 12 months for traditional medical claims beginning Jan. 1, 2022.
As Medicare enrollment approaches, ensure seniors in your life are prepared
Medicare open enrollment begins Oct. 15 and runs through Dec. 7. If you have elderly parents, aunts, uncles, or friends, talk to them about changes they want to make.
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.