Claims Processing
The House Energy and Commerce Health Subcommittee is looking at ways to move beyond the Sustainable Growth Rate formula, the current method of paying Medicare physicians.
Recovery Audit Contractors (RACs) have identified $365.8 million in improper payments made to Medicare providers from October 2009 through March 2011. The payments were issued as long ago as three years prior to the dates on which they were identified by the RACs, marking the limit of the lookback period in which contractors were allowed to search.
A new study by the National Center for Policy Analysis shows that states and the federal government could save $33 billion in prescription medication costs by switching to models used by Medicare and other private payers.
There are significant issues and potential concerns that hospital-based practices should be aware of with respect to ICD-10 implementation. By preparing early however, practices can alleviate several operational and budgetary issues.
The Department of Health and Human Services has launched a new initiative that will reward hospitals for the quality of care they provide to Medicare beneficiaries. HHS officials said the program would also help reduce healthcare costs.
Enrollment in consumer-directed health plans grew by 22 percent in 2010, according to a study commissioned by the American Association of Preferred Provider Organizations.
Enrollment in managed Medicaid plans is on the rise, according to Mark Farrah Associates, a Kennebunk, Me.-based data aggregator and publisher of health plan market data.
There are many steps that inpatient hospital providers can take to avoid denial of their claims when submitting Medicare fee-for- service claims.
Two owners of a seven-location chain of mental health clinics have pled guilty in Miami District Court for their roles in a scheme that resulted in the submission of more than $200 million in fraudulent Medicare claims.
After two decades of critical nurse and physician shortages, an economic climate of high unemployment would seem to be the antidote for the healthcare sector.