Having worked in both the private practice sector, hospital sector and payer sector in healthcare, I have seen things from all sides for both patient and provider. I am a firm believer in Pre-Visits and having the provider “set up” ahead of the patient visit. When I worked in for
PRE-VISITS – WHAT EXACTLY ARE THEY AND WHAT IS THE BENEFIT? Read More »
On January 17th, 2024, The Centers for Medicare & Medicaid (CMS), put forth the final rule for CMS Interoperability and Prior Authorization for payers and providers (CMS-0057-F). The final rule goes into effect as of 2026. The purpose of the final rule is to reduce patient, provider, and payer burdens
NAVIGATING THE PRIOR AUTHORIZATION CONUNDRUM Read More »
Whenever I am asked if an encounter qualifies for Incident To Billing, I always respond with “let me review the Medical Record first”. Generally, that is received with a few groans and some eyeball rolls, but it is a strongly suggested step in determining if the service provided is supported
AVOIDING INCIDENT WITH INCIDENT TO BILLING Read More »
