Medical Billing Blog: Section - Medical Billing

Archive of all Articles in the Medical Billing Section

This is the archive containing links to all articles written in the Medical Billing section of our blog.

Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.

Is the COVID-19 Pandemic Unraveling HIPAA Rules?

Art Gross poses a great question over at Health IT Answers… Is COVID-19 unraveling HIPPA?   “The Health Insurance Portability & Accountability Act (HIPAA) was created in 1996 to protect patients and their privacy, and if you are in healthcare, you already know this and are familiar with what it means. With a goal to ensure that people could maintain health insurance between jobs, thus the “Portability” part of the name; along with a second, and critical goal, to address the “Accountability” of insurance to protect the confidentiality part of patient information and data. This meant mandating standards of privacy for electrotonic protected health information (PHI) and data that was

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Poor Payer Reimbursements are Effecting Practices During COVID-19

HealthIT Answers posted an interesting article on how the pandemic is effecting providers. “Most physicians who have been practicing for a few decades remember the days when private payer reimbursements dwarfed Medicare reimbursements. That dynamic has long since flipped, starting with the 2008 recession. Reimbursements have been flat or have lost value from inflation, while practice costs have seen double-digit increases. Meanwhile, hospitals and insurance-owned health networks have seen reimbursements increase to 300% or more of Medicare in some cases, whereas it’s not uncommon for private practices to receive rates far below Medicare standards. Many practices have seen their volumes decrease from 30% to up to 90%, and a significant

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EHR and Interoperability Must Evolve to Integrate Genomic Data

“As genomic data becomes more prevalent and complex, EHRs must adapt and evolve to provide better patient care, according to a statement released by the American College of Medical Genetics and Genomics (ACMG). Genetic and genomic testing has become an important tool to enhance clinical decision-making and ultimately precision medicine. However, health IT, especially the EHR, are not able to integrate and interpret this data, ACMG said. In order to integrate genomic information into EHRs, amplifying patient autonomy, access, genetic literacy, privacy and protection, transferability of data, and assigning a data set must occur. “The electronic health record serves as a powerful interactive tool in improving the healthcare of patients

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6 Tips to Keep Your Finances Afloat During the COVID-19 Pandemic

Medscape offers 6 Tips to Keep Your Finances Afloat During the COVID-19 Pandemic…   1. Cut back on expenses Some household spending has naturally tapered off for many families, as social distancing restrictions reduce spending on eating out, travel, and other leisure activities. But this is also an opportunity to look for other ways to reduce spending. Look through your credit card bills to see whether there are recurring payments you can cut, such as a payment to a gym that’s temporarily closed or a monthly subscription box that you don’t need… 2. Take advantage of regulatory changes Although many physicians won’t qualify for direct payments via the Coronavirus Aid

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Better Data Collection is Key to Addressing EHR and Claims Data Discordance

“There is a moderate agreement between EHR data and Medicare Part D (MPD) claims data for the receipt of oral anticancer agents, which are a popular treatment option for cancer patients, according to a study published in JAMA Network Open. The study, conducted by the Texas Cancer Registry and The University of Texas MD Anderson Cancer Center (MDACC), found that 73.8 percent of the EHR data and MPD claims data overlapped, with 176 data sets shown in both and 123 sets not shown for either. Oral anticancer agents are becoming more popular and equally as expensive, leaving policymakers to uncover data about how patients use them, which then allows for

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EMR Documentation Issues During the COVID-19 Pandemic

Physician News posted a great article discussing EMR documentation issues during the pandemic. As hospitals are overwhelmed with COVID-19 patients and staff are stretched to their limits, electronic medical record (EMR) documentation may suffer as a result of rushed, less detailed and error-prone entries. EMR workarounds are also expected to flourish. In the current medical malpractice climate where greater scrutiny can be placed on the EMR and audit trail over the medicine itself, it is very important to maintain an accurate chart. There are steps that can be taken now to prepare for anticipated documentation issues related to care rendered during the COVID-19 pandemic. The most important recommendation is to

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97% of Physician Practices have been Financially Affected by COVID-19

According to Medscape, a recent survey shows that almost half of medical practices are having to furlough Staff, and 1 in 5 have had to layoff staff due to the financial strain of COVID-19. “Clinicians all over the country already likely know this, but a survey by the Medical Group Management Association (MGMA) makes it official: 97% of physician practices have experienced negative financial effects directly or indirectly related to COVID-19. The survey, which was conducted April 7 – 8, also shows that 55% of practices have seen a decrease in revenue, and 60% have experienced a decline in patient volume since the beginning of the COVID-19 crisis. A significant

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Five ways interoperability plays a role in addressing the coronavirus epidemic

HealthIT Answers has an article outlining five ways data interoperability can play a pivotal role in addressing the epidemic… “Even as capacity restrictions force organizations to work without barriers—via drive-thru screenings, make-shift tents or by way of telehealth—real-time access to data can help streamline care management, whether fast tracking admissions or empowering patients at home through online portals. Here are five ways data interoperability can play a pivotal role in addressing the epidemic: Coordination of Care: COVID-19 provides a sobering reminder of just how much a fully integrated, scalable and interoperable healthcare infrastructure is needed. Coordination among first responders, public health officials, labs, acute, and post-acute facilities will be critical

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Tips for Running Your Medical Practice during the Coronavirus Crisis

“At one large practice in Bergen County, New Jersey, the waiting room is empty — but its patients are still receiving care. As of mid-March, the practice is still operating, thanks to the group’s willingness to adapt its work flow, sometimes radically, to mitigate the threat of the COVID-19 pandemic. For example, patients now call the receptionist from their vehicles when they arrive, and wait there until receiving a call back telling them the clinician is ready. The practice has also started using telemedicine for the first time, to the extent it can be adopted in a hurry, and some clinicians are working from home on tasks such as medication

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7 things to consider when billing and coding for Coronavirus

Becker’s Hospital Review shows us 7 things to consider when billing and coding for Coronavirus…   1. CMS developed Healthcare Common Procedure Coding System code U0001 to allow laboratories and healthcare providers to bill for using the CDC’s RT-PCR Diagnostic Test Panel. Healthcare organizations should use HCPCS code U0002 to bill for validated, in-house developed COVID-19 diagnostic tests, according to CMS. 2. Beginning April 1, laboratories and healthcare providers can bill Medicare and other health insurers using codes U0001 and U0002 for services provided on or after Feb. 4. 3. Local Medicare Administrative Contractors will develop the payment amount for claims received for codes U0001 and U0002 in their respective

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