Reimbursement
New AMA research sheds light on the coverage policies of 16 commercial health insurers.
Costs for procedures such as mammograms and colonoscopies are as much as 58% higher when performed in HOPD settings.
For both primary and specialty care, telehealth is more frequently coded with a lower level-of-service billing code, Epic Research says.
AHEAD model includes financial incentives for hospitals and primary care practices.
Plaintiffs alleged that LVMC claimed and received payments that were not for "allowed medical expenses" permissible under state contracts.
In-person visits for mental health services dropped by 39.5%, while telehealth visits surged by 1019.3% over the prior year.
The court agreed that the calculation of QPAs used in dispute arbitration disadvantages physicians in payment disputes with insurers.
Expenses continued to rise in July, contributing to the decrease in margins as YTD operating margin dropped to 1.1%.
Long-term care hospitals cannot afford to absorb losses in outlier threshold calculation, says AHA.
Physicians who certify patient eligibility for hospice services must be enrolled in Medicare or have validly opted out.