Stay ahead industry change and revenue cycle trends, brought to you by the experts at Coronis Health.
This summer, Anthem—the Blue Cross/Blue Shield (BCBS) carrier for several states (California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin)—published an updated Anesthesia Services policy, with an effective date of November 1, 2024. The new policy statement contains language that will negatively affect reimbursement rates for many […]
On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule involving Medicare payments under the Physician Fee Schedule (PFS), as well as other Medicare Part B issues, effective on or after January 1, 2025. The proposed rule contains new implications for chronic pain providers, which are discussed below. Conversion […]
“I wish a Ford and a Chevy would still last 10 years like they should,” crooned country legend Merle Haggard back in the 80s. There was a perception back then that American products, in general, were falling behind in terms of their reputation for quality—especially when compared to foreign imports. In response, Ford initiated a […]
In the early 1980s, Medicare started reducing payment rates for anesthesia. Over the course of a few years, the disparity between commercial payment rates and Medicare rates continued to grow. This encouraged many practices to focus aggressively on payer contracting as a means of offsetting the impact of declining Medicare rates. For many years, this […]
The 2025 Outpatient Prospective Payment System (OPPS) proposed rule (PR) contains a number of provisions. Last week, we mainly focused on payment-related issues. Today’s article will focus on proposed changes to the hospital conditions of participation (CoPs)—a collection of requirements that has implications for whether or not a hospital can participate with the Medicare program. […]
On July 10, 2024, the Centers for Medicare and Medicaid Services (CMS) released its 2025 Outpatient Prospective Payment System (OPPS) proposed rule (PR) relative to hospital outpatient services. The following will act to summarize the key elements of the PR. General OPPS Payment The OPPS payment rates for hospitals that meet the applicable quality reporting […]
It has often been said that managing an operating room suite is like sitting on a three-leg stool where hospital administration represents one leg, the surgeons provide the second and anesthesia the third. Ideally, the administration defines the goals and objectives and recruits surgeons who are qualified and eager to produce. The problem is that […]
Ever feel like you’re drowning in medical codes and tangled in billing complexities? You’re not alone! Healthcare providers nationwide struggle with the ever-changing world of CPT codes and the time-consuming tasks associated with billing and coding. But fear not, there’s a friendly robot assistant waiting to lend a hand – Artificial Intelligence (AI). Hold on, […]
