Today, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to amend the methodology and other requirements for the U.S. Department of Health and Human Services’ risk adjustment data validation (HHS-RADV) program. HHS-RADV was created to strengthen the...

Some doctors don’t understand how coders compliantly select codes. This can set up coding-clinical disconnects. Frankly, I don’t always get it myself, and I’m pretty good at this coding thing.

While the introduction of new COVID-19 reimbursement rules and regulations have brought on their share of confusion, there is one certainty healthcare organizations can bank on: oversight of incentive dollars will be a regulatory priority. In fact, federal watchdogs are not wasting any time, as reports...

Faced with the unique circumstances under COVID-19, many skilled facilities are wondering how to make ends meet.  First things first: proper infection control procedures, getting proper personal protective equipment (PPE), and limiting the infiltration of COVID-19 into your...

The Centers for Medicare and Medicaid Services (CMS) released the final FY21 ICD-10-PCS codes on May 28, 2020 which was earlier than expected.  The table below will show the changes between Final FY20, Proposed FY21, and Final FY21:

A rapidly changing situation like the COVID-19 pandemic calls for a dynamic solution for tracking billing and coding changes for virtual services from different payers across multiple states. That's why revenue cycle leaders from Privia...

CMS’ announcement of telehealth reimbursement payment parity is a huge win for our community. After weeks of active engagement to CMS, Congress and the administration, CMS announced that it will reimburse audio-only E/M telehealth visits at the same rate as...

John Whyte, MD, MPH: You're watching Coronavirus in Context. I'm Dr John Whyte, chief medical officer at WebMD. Today we're going to talk about how COVID is changing the practice of medicine. I'm joined by Dr Bob Harrington, chair of the Department of Medicine at Stanford, and Bob Brisco, CEO of Internet Brands and WebMD. Gentlemen, thanks for joining me...

As the COVID-19 episode slowly winks out (for now­), hundreds of millions of Americans are confused, paying higher premiums and copays and getting refunds slowly, if at all. And yet, they are more aware than ever of the importance of the healthcare system and their need to access it. For many, it’s very difficult.