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PMB Blog

Posted on January 29, 2021 by PMB

Solving the Need for Telemedicine Billing Solutions During COVID-19

Before the global pandemic, who could have imagined a world where medicine shifted paradigms virtually overnight. While government officials and health leaders urged patients to stay at home, medical professionals struggled to continue providing quality care to their dedicated patients. It certainly expedited the timeline to expand medical practice adoptIon of telehealth services. Prior to

Posted on January 25, 2021 by PMB

Manual Claim Checks - What’s at Stake for your Organization?

Does your practice manually contact payers to check your claim status? Are you aware that doing so costs roughly $7 per attempt? Your revenue cycle management processes are vital to the financial health and wellness of your practice. Poorly managed handling of claim status inquires costs you not only money but precious time. A few

Posted on January 25, 2021 by PMB

3 Important Characteristics of Quality Medical Billing Companies

Physicians, medical practice owners, home health agencies, and hospice groups experienced a tremendous amount of stress during the COVID-19 pandemic. There were so many new challenges to navigate, especially as it relates to how to provide patient care. These challenges likely impacted your ability to focus on revenue cycle management, billing processes, dealing with insurance

Posted on January 14, 2021 by PMB

6 Financial Planning Best Practices for Home Health Agencies

When it comes to your finances, every element of your agency plays a significant role. How you work with your clients, train your staff, and implement focused business practices will determine how smoothly everything runs. On top of that, you need to be realistic about your company and how well you are doing financially on

Posted on December 17, 2020 by PMB

CMS Announces New Model Opportunity for Medicaid Managed Care Organizations Serving Beneficiaries Dually Eligible for Medicare and Medicaid

The Centers for Medicare & Medicaid Services’ (CMS) Center for Medicare & Medicaid Innovation is announcing a new opportunity to enable Medicaid Managed Care Organizations (MCOs) to better serve enrollees who are dually eligible for Medicare and Medicaid. This new Model opportunity is the first CMS initiative designed to harness the power of Medicaid MCOs

Posted on December 1, 2020 by PMB

Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2021

On December 1, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates on policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, on or after January 1, 2021. The calendar year (CY) 2021 PFS final rule is one of several

Posted on December 1, 2020 by PMB

Permanent Expansion of Medicare Telehealth Services and Improved Payment for Time Doctors Spend with Patients Finalized

The Centers for Medicare & Medicaid Services (CMS) released the annual Physician Fee Schedule (PFS) final rule, prioritizing CMS’ investment in primary care and chronic disease management by increasing payments to physicians and other practitioners for the additional time they spend with patients, especially those with chronic conditions. The rule allows non-physician practitioners to provide

Posted on December 1, 2020 by PMB

UPDATED: Emergency and Disaster Instructions

When a natural disaster, extreme weather or emergency occurs that affects providers and the Medicare beneficiaries that they serve, special emergency-related policies and procedures may be implemented. For detailed information on these policies and procedures, please see the following resources: For information when an applicable 1135 waiver   (PDF, 346 KB) has been granted For information on

Posted on November 20, 2020 by PMB

CMS Announces Historic Changes to Physician Self-Referral Regulations

On November 20, the Centers for Medicare & Medicaid Services (CMS) finalized changes to outdated federal regulations that have burdened health care providers with added administrative costs and impeded the health care system’s move toward value-based reimbursement. The Physician Self-Referral Law, also known as the “Stark Law,” generally prohibits a physician from making referrals to

Posted on October 26, 2020 by PMB

Preview 2021 Plans and Prices Ahead of the Upcoming Federal Health Insurance Exchange Open Enrollment Period

The Centers for Medicare & Medicaid Services (CMS) announced that starting today consumers can preview 2021 healthcare plans and prices on HealthCare.gov. This is an opportunity for consumers to compare coverage options ahead of Open Enrollment for the Federal Health Insurance Exchange, which officially kicks-off on November 1. As in previous years, window shopping allows

Posted on October 23, 2020 by PMB

Lawmakers Introduce New Bill Paving the Way for Home Health Telehealth Reimbursement

Home health providers are one step closer to getting the No. 1 thing they’ve been asking for since the COVID-19 pandemic began: reimbursement for telehealth-driven visits. On Friday, U.S. Senators Susan Collins (R-Maine) and Ben Cardin (D-Md.) introduced the Home Health Emergency Access to Telehealth (HEAT) Act, a bipartisan bill to provide Medicare reimbursement for

Posted on October 8, 2020 by PMB

CMS Announces New Repayment Terms for Medicare Loans made to Providers during COVID-19

The Centers for Medicare & Medicaid Services (CMS) announced amended terms for payments issued under the Accelerated and Advance Payment (AAP) Program as required by recent action by President Trump and Congress.  This Medicare loan program allows CMS to make advance payments to providers and are typically used in emergency situations.  Under the Continuing Appropriations

Posted on September 17, 2020 by PMB

PMB listed as one of the healthcare revenue cycle companies to know in 2020 from Becker’s Hospital Review

Published: September 2020 Healthcare revenue cycle companies to know | 2020 List Hospitals, health systems, physician practices and healthcare organizations are experiencing increasingly complex revenue cycles, working with government and private payers as well as patients to collect. Precision Medical Billing was launched in 1995 and is dedicated to helping physicians, home health agencies and

Posted on April 1, 2020 by PMB

Major Changes Are Coming to E/M Visits in 2021: Will You Be Ready?

The documentation guidelines set forth by the Centers for Medicare & Medicaid Services (CMS) for evaluation and management (E/M) services, established 20 years ago, do little to support patient care. Instead, they serve more as a scoring system to justify a level of billing (e.g., level 3, 4, or 5), rather than helping physicians diagnose,

Posted on November 14, 2019 by PMB

Action needed: Register for an iQIES Account

The Quality Improvement and Evaluation System (QIES), which providers and vendors use to submit assessment data, is being upgraded to make the system more reliable, scalable, secure, and accessible.  The enhancements will occur in phases (by provider type) and began with Long- Term Care Hospitals (LTCHs) in March 2019, followed by Inpatient Rehabilitation Facilities (IRFs)

Posted on November 1, 2019 by PMB

Congress Debates Bill to Automate Prior Authorization in Medicare Advantage Plans

Recently the House of Representatives’ Small Business Committee convened for a hearing on utilization management and barriers to care in small medical practices. In particular this hearing focused on the application of prior authorization within Medicare Advantage (MA) plans and the associated challenges faced by patients and providers of services due to prior authorization requirements.

Posted on November 1, 2019 by PMB

Physician Stark Law Rules Revamped: New Rules Address Care Coordination

This is the first major update to rules for the Stark law since 1989, according to HHS. An HHS press statement explained that the new rules would give providers in value-based arrangements “greater certainty” and “ease the compliance burden for healthcare providers across the industry,” while maintaining protections against fraud and abuse. Clinicians and hospital

Posted on October 31, 2019 by PMB

Home Care Agencies Often Wrongly Deny Medicare Help To The Chronically Ill

Colin Campbell needs help dressing, bathing and moving between his bed and his wheelchair. He has a feeding tube because his partially paralyzed tongue makes swallowing “almost impossible,” he said. Campbell, 58, spends $4,000 a month on home health care services so he can continue to live in his home just outside Los Angeles. Eight

Posted on October 31, 2019 by PMB

3 Benefits of Value-Based Care

The U.S. healthcare industry is moving toward value-based care, encouraged by reimbursement initiatives from the Centers for Medicare and Medicaid Services (CMS). In a value-based model, providers are paid depending on patient outcome rather than on volume of procedures performed. Theoretically, this would promote a focus on patient wellness and preventative medicine, which would improve

Posted on October 30, 2019 by PMB

CMS Delays Collapsing of E/M Payment Rates Until 2021

Implementation of a single E/M payment rate for office visit Levels 2 through 4 won’t go into effect until 2021, CMS stated in the new Physician Fee Schedule rule. November 01, 2018 – CMS will collapse evaluation and management (E/M) payment rates, but not until the 2021 calendar year, according to the recently released final 2019

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