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With the introduction of new medical codings for Medicare proposed by the Centers for Medicare & Medicaid Services (CMS), healthcare providers are worried this will have a negative effect on the quality of care that they are able to provide to patients. To learn more about these proposed coding changes, continue reading. AMGA has asked…
DetailsColorado lawmakers have introduced new legislation which funds numerous departments including the Department of Health Care Policy and Financing. With the funds for the 2023-2024 budget, the HCPF plans to focus on Medicaid, health equity, behavioral health, and more. To learn more details and how this could affect you, continue reading. The legislature approved appropriations…
DetailsHealthcare service company Cigna will now require documentation to be submitted for all E/M services. Several medical groups wrote letters to Cigna stating this would be a burden on medical providers. The new policy has the potential to worsen the already struggling relationship between medical providers and patients. Continue reading to learn more details on…
DetailsThe HHS Office of Inspector General’s (OIG) announced on April 25th that after nearly 23 years, the compliance guidelines for individual and small group physician practices will undergo a major overhaul. The first round of the upgrades could be rolled out by the end of 2023, according to the Federal Register notice “Modernization of Compliance…
DetailsTelemedicine has been on the rise for years, but the COVID-19 pandemic accelerated its adoption as a vital tool for providing healthcare remotely. One of the most significant obstacles to its widespread adoption, however, has been the strict regulations around prescribing medication via telemedicine. The DEA has once again modified its guidelines, expanding the list…
DetailsIt is Patient Experience Week! We are celebrating the cycle leaders and all of the hard work they’ve done and continue to do for the benefit of patients. Educating patients on guiding the billing process is crucial in ensuring a positive experience. To learn more about the essence of patient education and why we celebrate, continue…
DetailsThe Centers for Medicare & Medicaid Services (CMS) has released its 2024 Medicare Advantage (MA) and Part D Final Rule. Providers, who have been lobbying for prior authorization reform for years, will find the changes to prior authorization policies, particularly significant. Healthcare experts agree that the prior authorization rule is a big win for providers.…
DetailsIn today’s fast-paced healthcare market, patients are no longer loyal to a single provider network and split their care across multiple networks. Healthcare providers must leverage data and establish metrics to understand patients as consumers and meet their needs. Incorporating consumer-focused metrics into strategic planning presents challenges but it’s crucial for health systems to remain…
DetailsWith an average of 1.2 seconds spent on each case, doctors may not see any patient records or use their medical judgment. Instead, a computer algorithm flags a mismatch between diagnoses and tests/procedures for those ailments. Former Cigna employees revealed that company doctors then sign off on the denials in batches. Because of this insurers…
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