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Reimbursement

By Susan Morse | 04:42 pm | September 28, 2023
While 80% of a commercial bill is the plan's responsibility, 20% is owed by patients, says PayMedix CEO Tom Policelli.
By Jeff Lagasse | 10:58 am | September 26, 2023
Coverage of digital medicine CPT codes varies wildly, which makes it difficult for physicians to reliably provide digital services.
By Susan Morse | 10:54 am | September 22, 2023
At least 7.1 million Medicaid enrollees have been disenrolled as of September 20, according to KFF.
By Susan Morse | 10:10 am | September 20, 2023
New AMA research sheds light on the coverage policies of 16 commercial health insurers.
By Jeff Lagasse | 02:01 pm | September 17, 2023
Costs for procedures such as mammograms and colonoscopies are as much as 58% higher when performed in HOPD settings.
By Susan Morse | 11:46 am | September 15, 2023
For both primary and specialty care, telehealth is more frequently coded with a lower level-of-service billing code, Epic Research says.
By Susan Morse | 10:54 am | September 06, 2023
AHEAD model includes financial incentives for hospitals and primary care practices.
By Jeff Lagasse | 04:00 pm | September 05, 2023
Plaintiffs alleged that LVMC claimed and received payments that were not for "allowed medical expenses" permissible under state contracts.
By Nathan Eddy | 10:31 am | September 01, 2023
In-person visits for mental health services dropped by 39.5%, while telehealth visits surged by 1019.3% over the prior year.
By Jeff Lagasse | 12:14 pm | August 29, 2023
The court agreed that the calculation of QPAs used in dispute arbitration disadvantages physicians in payment disputes with insurers.