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A recent survey conducted by AMA reveals that practices are reporting an average of 37 prior authorization requests each week, eating up an average of 16 hours of both physician and staff time. Check out the article, below, by Health Leaders Media, outlining the results of the survey. The healthcare industry hasn’t eliminated the hassles…
DetailsFormer Aetna CEO claims Obamacare is flawed, read more below about what former Aetna CEO Ronald William’s has to say about Obamacare. Since the Affordable Care Act became law in 2010, making the math work has been a real challenge. For Obamacare to be sustainable, the insurance “risk pool” equation has to work. Premiums from young, healthy…
DetailsAnthem CEO Joseph R. Swedish appeals the federal judge’s decision to merge with Cigna and claimed merger would save consumers $2 billion in medical costs. Read more about the Anthems appeal below. Anthem CEO Joseph R. Swedish said he was “significantly disappointed” with the federal judge’s decision and claimed the merger would save consumers more…
DetailsThe proposed merger of Aetna Inc. and Humana Inc. was blocked by a United States Federal Judge earlier this week. Read more about this in the article below. A U.S. judge blocked on Monday health insurer Aetna Inc’s proposed $34 billion acquisition of smaller peer Humana Inc, raising the stakes for rival Anthem Inc as…
DetailsThe Affordable Care Act (Obama Care) looks to be the first target of a Republican dominated House, Senate and President! Much in the ACA is entangled in the current tax code. It will not be as simple as defunding it. The employer and individual mandates, the premium tax credit, the (so called) Cadillac Tax, the…
DetailsTom Price’s Vision – Commercial & Individual Encourage Private Exchanges for purchase of individualized products across state lines Create federal Grants for States to create high-risk pools Eliminate individual Mandate Comprehensive Medical Liability Reform allowing conformity to clinical guidelines to serve as an affirmative defense to liability Claims Transparency from insurers to employers and individuals…
DetailsWritten By: Toni Elhoms, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer Director of Coding/Compliance Consulting Services It’s that time of the year again! The new 2017 CPT code changes take effect January 1st. Understanding the myriad of upcoming changes is crucial to obtaining the proper reimbursement for your services! The changes for 2017 address a number of…
DetailsModerate sedation services have historically always been bundled into the majority of all applicable CPT procedures. More than 400 codes that were previously defined as including moderate sedation have been deleted from Appendix G. In addition to six new CPT codes and one new endoscopy-specific HCPCS code, CMS intends to create a “uniform methodology for…
DetailsEffective Jan. 1st, CMS will begin paying for complex CCM services (99487-99489) in addition to normal CCM (99490). These CPT codes have been around for a while, but CMS has always refused to reimburse for them. Keep in mind, to get paid, you must be able to properly note all the moving parts of this…
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