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Payment for Medications: It’s an Exacting Team Sport!

Getting paid for drugs demands a robust chain of events linking product procurement, its use within both the clinical framework and payer requirements, and the revenue cycle function of charging, billing and subsequent reimbursement.

Using Modifiers to Untangle Billing for Waste

Using Modifiers to Untangle Billing for Waste

Even with the coding sets used to reimbursement healthcare expenses, it is sometimes necessary to increase the specificity of the data or to add a contingency of payment by adding modifiers.

2024 OPPS, ASC and PFS Proposed Payments

The proposed calendar year 2024 Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center (ASC) and Physician Fee Schedule (PFS) payment rule sets are being finalized to begin Jan. 1, 2024.

Potential Disruptors: 2023 and Beyond

Potential Disruptors: 2023 and Beyond

Financial Challenges remain a consisten t and growing concern for the healthcare industry, so taking actionable steps to produce tangible results can assist the industry in righting itself after uncertain times of financial instability.

Proposed Payment Systems and Fee Schedules in 2023

Doctor reviewing payment fee schedules

Proposed rules revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) services, along with new physician fee schedule (PFS) rule sets will significantly impact providers in 2023. 

Drug Vial Sizes, Waste and Recovering Costs

Photo of various-sized drug vials and syringe

Manufacturers have mainly stayed on the periphery of the discussion about how to remedy the issue of unused or wasted drugs from single-use vials, but the REFUND Act is changing that.