Changes coming in 2021 2020 looks to be a transition year on the payment front, as many programs and changes expected to go into effect this year have been delayed until 2021. These include new CMS-created primary care models and a streamlining of evaluation and management level-of-care coding. CMS announced in October its newest alternative […]
EAPG
Blue Cross Blue Shield Enhanced Ambulatory Patient Grouping (EAPG) methodology for calculating reimbursement for outpatient procedures http://www.okoha.com/OHA/Hotline/2015/April15/Taking_charge_of_the_EAPG__Improve_your_negotiations_with_BCBS.aspx
Developing Financial Assistance Policies with the Latest IRS Rules in Mind
http://www.hfma.org/Content.aspx?id=32027#.VgNfflVcR_w.mailto Financial assistance programs IRS rules on hospital FAP’s
Office of Medicare Hearings and Appeals (OMHA)
With the two midnight rule becoming effective, this website is a good resource for information. Office of Medicare Hearings and Appeals (OMHA) OMHA administers appeal hearings for the Medicare program. There are five levels in the Medicare claims appeal process. OMHA’s Administrative Law Judges hold hearings and issue decisions related to Medicare coverage […]
CMS Clarifies Insurance Assistance Rules
Feb. 14—Healthcare foundations can pay for coverage by insurance plans offered on new government-run marketplaces, according to recent federal guidance. The 2014 launch of health insurance marketplaces, which were created by the Affordable Care Act, has increased the interest of hospitals and health systems in helping their patients afford either the premiums or out-of-pocket costs […]
Resolution of the Patient portion of Medical Bill
This document is based on the deliberations of the Medical Debt Collection Task Force. It reflects the task force’s consensus on the current state of best practices related to the equitable resolution of the patient portion of medical bills. The appropriate resolution of the patient portion of bills related to medical services continues to present […]
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