By Ranadene (Randi) K. Tapio, MBA, CMRS, CMC, Guest Contributor bio When patients have multiple insurance coverage, at times it can be difficult to determine which one is primary, secondary, and tertiary. Sometimes, the patients don't even know which order they go in! While there are always going to be exceptions, here are some basic guidelines to keep in mind: … [Read more...] about How to determine the order of multiple insurance coverages
Medicaid
CMS finalizes changes to the Medicare Physician Fee Schedule and Quality Payment Program
Last week, the Centers for Medicare & Medicaid Services (CMS) finalized proposals that it says will address provider burnout and provide clinicians immediate relief from excessive paperwork tied to outdated billing practices. The final 2019 Physician Fee Schedule (PFS) and the Quality Payment Program (QPP) rule also updates Medicare payment policies to promote access to … [Read more...] about CMS finalizes changes to the Medicare Physician Fee Schedule and Quality Payment Program
2018 Medicare Reimbursement: Final Rule
By Elizabeth Woodcock, Guest Contributor bio Just hours within the release of the Final Rule concerning the 2018 revisions to the Quality Payment Program (QPP) on November 2, the Centers for Medicare & Medicaid Services (CMS) published the ruling that governs the Medicare Physician Fee Schedule (PFS) for the coming year. Although overshadowed by the QPP … [Read more...] about 2018 Medicare Reimbursement: Final Rule
Quality Payment Program (QPP) Final Rule Released November 2
By Elizabeth Woodcock, Guest Contributor bio According to the Centers for Medicare & Medicaid Services (CMS), flexibility is the purported theme of the QPP Final Rule, which was issued under its official title, the Medicare Program; CY 2018 Updates to the Quality Payment Program; and Quality Payment Program: Extreme and Uncontrollable Circumstance Policy for … [Read more...] about Quality Payment Program (QPP) Final Rule Released November 2
2018 Health Insurance Exchanges Issuer County Map
The Centers for Medicare and Medicaid Services has posted an update to the Health Insurance Exchanges Issuer County Map. This map is of projected issuer participation on the Health Insurance Exchanges in 2018 based on the known issuer public announcements through August 23, 2017. Participation is expected to fluctuate and does not represent actual Exchange application … [Read more...] about 2018 Health Insurance Exchanges Issuer County Map
Now available: 2017 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals, Schematron, and sample files
The Centers for Medicare & Medicaid Services (CMS) has published the 2017 CMS Quality Reporting Document Architecture Category III (QRDA III) Implementation Guide (IG) Version 1.0 (7/07/2017) for Eligible Clinicians and Eligible Professionals (EPs) Programs with Schematron and sample files. This version replaces the 2017 CMS QRDA III IG for Eligible Clinicians Reporting … [Read more...] about Now available: 2017 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals, Schematron, and sample files