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 […]

CMS Issues New Roadmap for States to Address the Social Determinants of Health to Improve Outcomes, Lower Costs, Support State Value-Based Care Strategies

The Centers for Medicare & Medicaid Services (CMS) issued guidance to state health officials designed to drive the adoption of strategies that address the social determinants of health (SDOH) in Medicaid and the Children’s Health Insurance Program (CHIP) so states can further improve beneficiary health outcomes, reduce health disparities, and lower overall costs in Medicaid […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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, […]

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) […]

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. […]

Increased Enforcement Against Home Health Agencies

With the recent rise in medical services provided outside of a doctor’s office, there has been a surge of FCA enforcement actions against home health agencies (HHAs). HHAs are public or private agencies or organizations that are primarily engaged in providing skilled nursing services and other therapeutic services to patients in their residence.[1] The last […]

American medical students less likely to choose to become primary care doctors

Despite hospital systems and health officials calling out the need for more primary care doctors, graduates of U.S. medical schools are becoming less likely to choose to specialize in one of those fields. A record-high number of primary care positions was offered in the 2019 National Resident Matching Program—known to doctors as “the Match.” It […]

Medicare decides a cost-saving strategy costs too much

After pushing more medical care out of hospitals and into patients’ homes, the federal government wants to pay less for home health care. Impending changes in Medicare’s home health payment system would dramatically alter how agencies are reimbursed for services, cutting payments by 8 percent. Lower rates would squeeze profit margins in what has been […]

Medicare Sequester Extended Two Years

The Bipartisan Budget Act of 2019, signed into law last week by President Donald J. Trump, includes an extension of the Medicare sequestration cuts for an additional two years. This across the board cut of two percent applies to all Medicare provider payments. The Bipartisan Budget Act of 2019 will increase federal spending by $320 […]

CMS Is Putting Primary Care First

Beginning January 2020, primary care practitioners may qualify to participate in one of five new payment model options that focus on supporting care for patients who have chronic conditions and serious illnesses. The Centers for Medicare & Medicaid Services’ (CMS) Primary Care Initiative is a new set of payment models that will provide primary care […]

When A Doctor’s Screen Time Detracts From Face Time With Patients

As Wei Wei Lee sat with her doctor to discuss starting a family, she felt a “distance” between them. The physician was busy on the computer and focused on the screen. Health care — and how much it costs — is scary. But you’re not alone with this stuff, and knowledge is power. “An Arm […]