Reimbursement

The American healthcare system is clearly evolving. Although dramatic changes are likely, these changes will be neither instant nor universal. Read More ›

As most of us know, poor previsit processes create havoc on a practice’s ability to post, bill, and collect for services rendered (Petaschnick J. Health Care Collector. 2007;20:1,10-12). Read More ›

The deadline for going live with the International Classification of Diseases (ICD), 10th edition is October 1, 2013, and the Centers for Medicare & Medicaid Services repeatedly has attested this as a firm deadline with no extensions, delays, or grace periods. Read More ›

This has proven to be a difficult year for reimbursement for community cancer care providers. Al - though there are many hurdles to appropriate reimbursement, 3 issues are hanging fire in Congress this year. The sustainable growth rate (SGR) formula remains unfixed. Drug manufacturers’ promptpay discount is still calculated in the average sales price (ASP) for physician reimbursement. And most recently, select members of Congress are considering across-the-board cuts of up to 2% in Medicare reimbursement. Read More ›

It is no secret federal auditors promise to assail providers through a variety of strong recoupment initiatives. Evaluation and management (E/M) services are primed for this offensive. Read More ›

Given the reimbursement climate, there is growing concern that the economics of private medical oncology practices are no longer sustainable. As such, many oncologists are evaluating alignment options with hospital partners who, in turn, are seeking to strengthen their oncology service lines. Read More ›

With preparation, you can negotiate favorable reimbursement from man aged care and other contracted payers. To do so, you will need to develop a contracting strategy be fore each negotiation. Read More ›