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What Hospitals Should Do About Payment Changes in 2013

In response to the government’s continued focus on improving quality of care through payment policy, several changes to new and existing regulatory requirements recently came about through the 2013 Inpatient Prospective Payment System (IPPS), Outpatient Prospective Payment System (OPPS), and the Medicare Physician Fee Schedule (MPFS) Final Rules (“Final Rules”). As a result, hospitals will…

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2013 Credentialing & Reimbursement Updates – Important!

Medicaid Primary Care Payment Increase The Affordable Care Act (ACA) enacted changes to Medicaid primary care reimbursement. Eligible physicians will receive supplemental payments for services rendered between January 1, 2013 and December 31, 2014. These supplemental payments will raise the Medicaid reimbursement to Medicare rates. To be eligible for the supplemental payments, physicians must self-attest…

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2013 CPT Changes!

Per AMA guidelines, the new code set should be used for claims filed as of January 1, 2013. Practices are advised to check with their local payers to verify payer implementation date of the new codes, to avoid any unnecessary claims denials and delays in payments!

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AHRQ Report Finds Teamwork Key to Long- Term Sustainability of Health IT Systems

A new report from the Agency for Healthcare Research and Quality (AHRQ) highlights the cumulative experiences of more than 100 grantees that implemented major health IT projects between 2004 and 2007. The report, Effective Teamwork and Sustainability in Health IT Implementation, reviews grantee experiences related to planning, long-term use, partnerships, vendor relationships, and end-user perceptions…

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SGR Fix Hostage to Fiscal Cliff Debate

Physicians are scheduled to reSGR Fix Hostage to Fiscal Cliff Debateceive a 26.5 percent reduction in payments starting Jan. 1 unless Congress intervenes. Action to avert the cut is being considered as part of broader fiscal cliff negotiations on tax and spending policies. However, these discussions remain up in the air, creating uncertainty over the timing of a solution.

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ACOs Serve Nearly 10 Percent Of Americans

Almost 10 percent of U.S. patients receive their healthcare from an accountable care organization (ACO), and almost half live in areas served by at least one ACO, according to a new study from Oliver Wyman. This means that ACOs, little known in the United States as recently as two years ago, now have a substantial…

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