The Centers for Medicare & Medicaid Services (CMS) have announced the scheduled release of adjustments to the Healthcare Common Procedure Coding System (HCPCS) code set. The changes can be found on the CMS website www.cms.gov. Changes are effective on the date...
Explore the Latest Resources from the Medbill Team
Stay informed with Medbill’s blog, where we share expert guidance, practical tips, and industry updates to help DME providers navigate the industry’s complexities.
Reimbursement
Insurer and Michigan Hospitals Switch Reimbursement Plan
Michigan's largest health insurer and a dozen hospitals announced Monday they are starting to carry out a cost-saving deal designed to prevent unnecessary or overused tests and procedures, an attempt to put less emphasis on the traditional way providers are reimbursed...
CMS Delays PECOS Phase 2 Implementation
On Thursday April 25th, 2013 CMS Announced that due to Technical issues, implementation of the Phase 2 ordering and referring denial edits is being delayed. The edits would have checked the following claims for an approved or validly opted-out physician or...
Pennsylvania-Based Health Plan Engages with its Providers through an Analytics Platform
Independence Blue Cross and Abington Health have are collaborating on an initiative that could transform the reimbursement landscape of southeast Pennsylvania Earlier this spring, Abington Health, a two-hospital integrated health system based in Abington, just north...
NAHC Participates in Call with CMS on Phase II PECOS Edits
The National Association for Home Care & Hospice participated in a conference call with the Centers for Medicare & Medicaid Services on April 3, 2013 to discuss Phase II of the PECOS edit activation. During the call, NAHC reported on the information collected...
Court Ruling Opens Door for Providers to Seek Reimbursement for Medicare Bad Debts
Providers may be reimbursed for Medicare beneficiaries' bad debts even after sending them to a collection agency, a U.S. District Court judge has ruled. At issue was the question of whether bad debts for Medicare beneficiaries, usually related to copayments and...
NV Medicare Patients Told to Find New Insurance Provider
Hundreds of Medicare recipients in Southern Nevada have been forced to change insurance carriers after their provider was liquidated amid fraud allegations. Universal Health Care Insurance Co., which had about 1,800 customers in Clark County, was placed into...
NC Governor wants Medicaid Patients in Managed Care Plans
RALEIGH — Gov. Pat McCrory wants to overhaul the state’s Medicaid program by having managed care companies offer health care plans for poor children, the elderly and the disabled. McCrory said Wednesday that the change would benefit health care providers, patients and...
California Tests New Model for Medicare-Medicaid Enrollees
On March 27, 2013, the Department of Health and Human Services announced that the State of California will partner with the Centers for Medicare & Medicaid Services (CMS) to test a new model for providing Medicare-Medicaid enrollees with a more coordinated,...
U.S. to Raise Medicare Advantage Payment Rate
In a reversal that followed intense lobbying from the health insurance industry and members of Congress, the U.S. government said it will increase the payment rate for health insurers that offer coverage through the popular Medicare Advantage program. The Centers for...
Triangle Area DME Providers – Time to Ask for MPP Support
ATTENTION TRIANGLE AREA PROVIDERS - Let's attend and ask Congressman Price to support the Market Pricing Program - legislation soon to be introduced by Dr. Tom Price (R-GA) The message below is from Congressman David Price (D-NC4)... On Monday, April 8 from 6:00 –...
100 Percent Funding for New Medicaid Beneficiaries Finalized
Health and Human Services (HHS) Secretary Kathleen Sebelius today announced a final rule with a request for comments that provides, effective January 1, 2014, the federal government will pay 100 percent of the cost of certain newly eligible adult Medicaid...