The American Medical Association’s (AMA) National Health Insurer Report Card (NHIRC) provides physicians and the general public a reliable and defensible source of critical metrics concerning the timeliness, transparency and accuracy of claims processing by health insurance conplanies. Billions of dollars in administrative waste would be eliminated each year if third-party payers sent a timely, accurate and specific response to each physician claim.
Last week, we sent out a special alert advising our readers of a change in Aetna’s payment policy in connection with physical status (PS) modifiers on anesthesia claims. The payer announced it would no longer provide additional payment for PS 3-5, effective July 15 of this year. Not to be outdone, several of the “Blues” […]
On April 10, 2024, the Centers for Medicare and Medicaid Services (CMS) issued the fiscal year (FY) 2025 Medicare hospital inpatient prospective payment system (IPPS) proposed rule. While these provisions are not final, they do give current insight into the agency’s thinking in terms of a host of issues concerning the inpatient hospital setting, including […]
We’ve come a long way since the days when the milkman would make his deliveries at the door and the doctor would make house calls, black bag in hand. Now, we order our goods online and we can even see our healthcare professional via the latest telecommunications technology. Americans love convenience, and it is certainly […]
