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Reimbursement

July 13, 2021
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How to ensure a positive patient financial experience

When it comes to improving the patient experience, providers tend to focus on the front-end experience. Whether it’s enhancing point-of-service interactions or clinical touchpoints in the patient journey, these aspects of patient experience are crucial. But they’re not the only ones impacting net promotor scores (NPS) and HCAHPS results.

doctor with money and calculator
July 13, 2021
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Why fee-for-service can have a place in a reimagined healthcare system, but not as the primary mode of payment

Fee-for-service has been coming under increasing scrutiny in recent years, but the healthcare industry shouldn’t dismiss it as a mode of payment altogether.

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June 8, 2021
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Weeding out waste: Policy workshop examines how the healthcare industry can finance a better model

As the U.S. healthcare industry makes an increasingly concerted effort to move to population health management, the key question is how to pay for such a transformation.

 

Categories: Reimbursement
graphic with money, calculator and stethiscope
April 28, 2021
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Congress averts Medicare cuts set to hit radiologists, sending final bill to president

The U.S. House finalized legislation in a 384-38 vote Tuesday, averting 2% Medicare pay cuts set to hit radiologists and other physicians. Following passage in the Senate, President Joe Biden signed the bill on Wednesday, April 14.

Categories: Reimbursement
April 12, 2021
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Better integration with primary care can help address the ongoing mental health and addiction crisis, report finds

Integrating primary care and behavioral healthcare can shore up the nation’s capacity to address the surging mental health crisis, according to a new report. Existing value-based payment structures can be deployed to promote the availability of high-quality behavioral healthcare.

April 12, 2021
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How has reduced reimbursement for acromioplasty impacted your patients and practice?

Although reduced reimbursement for acromioplasty has negatively impacted me financially, it has not impacted my patients. I still use the patient’s clinical history, symptoms and surgical findings to perform acromioplasty when I consider it to be helpful based on evidence-based medicine, logic and my experience. In 2012, code 29826 was changed to an add-on code and was reduced from 9.16 relative value units (RVUs) to 3 RVUS. That reduction in reimbursement had a moderate negative financial impact on my practice for Medicare patients.

Throwing away money
March 16, 2021
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CPT code blunders cost one radiology practice more than $20K per month, new analysis shows

Delays in adopting new current procedural terminology codes cost one academic radiology practice hundreds of thousands of dollars in revenue, according to a new analysis.

March 5, 2021
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Low-value care spending drops marginally, despite best efforts

Despite efforts to educate clinicians and increase payment revisions, little has changed in the amount spent on low-value healthcare for traditional fee-for-service Medicare patients.

March 5, 2021
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4 Ways To Keep Ahead Of Denials Amid The Pandemic

Understanding all that’s required to secure healthcare payment during a pandemic — especially for services related to COVID-19 — demanded that revenue cycle teams quickly refine denials management processes to protect their organization’s financial health. It also necessitated a spirit of patience and understanding toward payers, which faced a similar learning curve. 

Categories: Reimbursement
March 5, 2021
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Pandemic, changes in health care spur practice consolidation

Published literature has shown the postponement and cancellation of elective procedures during the COVID-19 pandemic had a substantial financial impact on orthopedic practices and hospitals. In a study in International Orthopaedics, Matthew J. Best, MD, and colleagues estimated hospital losses of $10.9 to $11.9 billion in reimbursement and $2.6 to $3.5 billion in net income due to canceled elective musculoskeletal surgery during 8 weeks of the COVID-19 pandemic.

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