Reimbursement FAQs Articles
The interrelationship between three major issues —ICD-10 conversion, the increasing burden of recovery auditor contractor audits and the need to streamline authorizations and meet local coverage determination and national coverage determination requirements— presents an interesting opportunity.
In light of the angst and hand-wringing over the soaring costs of biologic drugs that are alleged to be contributing to the unsustainability of biologic treatments, the U.S. Food and Drug Administration (FDA) approval of the first biosimilar in the U.S. was welcome news to many.
In late January, the Department of Health and Human Services (HHS) announced that it would fundamentally reform how it pays providers for treatingMedicare patients in the coming years. Speeding up the transition from fee-for-service to pay-for-performance and forcing Medicare to commit to this payment
On Oct. 31, the Centers for Medicare and Medicaid Services (CMS) issued the calendar year 2015 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory SurgicalCenter Payment System Policy Changes and Payment Rates final rule [CMS-1613-FC].
Understanding how to bill for waste and changing HCPS codes, and how to sign up for MLN Matters newsletters.
Complexity is the operational word for reimbursement, and this includes the rules and nuances that govern drugs and biologicals. Here is a summary of important 2014 issues.
Annual CPT code set changes affect all provider types that provide CPT professional services in all states.
Billing codes used to seek reimbursement for Hizentra, including supplies, pump and nursing, for a primary immunodeficiency disease
Reimbursement rates for infusion medications; reimbursement process for infusion centers; and what to do if when employer carrier changes result in denied coverage.
Exploring the new ICD-9 code for acquired hemophilia and Medicare reimbursement for in-home nursing services.
Addressing questions regarding reimbursement for subcutaneous immune globulin in patients with primary immunodeficiency.
Several advocacy groups are focusing their efforts on reimbursement issues that they believe threaten patients’ access to care.