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On September 11, 2023, the FDA authorized, for emergency use (EUA), the 2023-2024 formulations of the Pfizer-BioNTech and Moderna COVID-19 vaccines for individuals ages 6 months and older. This new formulation includes a monovalent component corresponding to the Omicron XBB.1.5 variant. The FDA simultaneously rescinded the authorization for bivalent vaccines for use in the United […]

The recent changes to UnitedHealthcare’s colonoscopy coverage have sent shockwaves through the medical community. Gastroenterologists and patients alike are grappling with the implementation of a controversial process called prior authorization, which has the potential to create barriers to essential diagnostic and surveillance colonoscopies. The Impact of UnitedHealthcare’s Policy UnitedHealthcare’s decision to require prior authorization for […]

The Shift Toward RCM Partnerships in the Healthcare Industry In today’s rapidly changing healthcare landscape, revenue cycle management (RCM) plays a pivotal role in maximizing return on investment (ROI) for healthcare providers. As per the latest research from the esteemed 2023 Black Book healthcare survey, the industry as a whole is increasingly turning toward third-party […]

By implementing the American Rescue Plan, the Biden administration is delivering its promise to bring down healthcare costs. Believing that the people deserve the peace of mind that comes from knowing they can take care of their health without going into debt is the inspiration behind the strengthening of the Affordable Care Act. The plan […]

Even before the pandemic, many primary care providers were struggling with unsustainable practice costs and burnout. COVID-19’s disruption of the healthcare delivery system, however, poses additional challenges to primary care. According to a recent survey, facilities must adapt to shifting workflows, implementing new billing and coding practices, and building platforms for telehealth services—all while dealing […]

The newly enacted American Rescue Plan centers on the ongoing battle against the COVID-19 pandemic and rebuilding the economy amidst the public health crisis. This means that the $1.9 trillion COVID-19 relief plan will impact hospitals and other primary healthcare providers fighting the virus and have implications for health systems, including new coverage policies.  With […]

The Centers for Medicare & Medicaid Services (CMS) recently increased Medicare’s reimbursement rates for hospitals, pharmacies, physicians, and others for administering COVID-19 vaccines. These changes by CMS are in support of the administration’s efforts to ensure that all Americans can be vaccinated against COVID-19 as soon as possible. The pandemic has certainly resulted in rapid […]

By Allison Bloom, Director of Coding Operations, and Lisa Messina, Corporate Compliance Officer, FQHC Division of Coronis Health Updated February 5th, 2022 to include new Pediatric COVID-19 Vaccine codes and information in advance of FDA EUA approval. The COVID pandemic has had tremendous emergent impact upon medical care, testing, and supplies. In response, the AMA’s […]

The American Hospital Association (AHA) surveyed more than 200 hospitals and health systems in 2019 to explore how commercial health plans employed utilization management practices for patients and providers. AHA found that 89% of the respondents have experienced an increase in claims denials over the past three years. 51% of them even described such increase […]

For decades, healthcare providers have voiced their issues with the growing amount of data entry required for Evaluation and Management (E/M) visits. Some have even complained about spending twice as much time on the documentation process related to caring for patients. For the first time in almost 30 years, the Centers for Medicare & Medicaid […]