The article discusses issues related to hospital stay of patients and its cost implication on the patient, hospital and the Medicare program. It is noted that rules have been issued by the Centers for Medicare and Medicaid Services (CMS) to provide guidelines to hospitals for inpatient admissions...
HCPCS billingcodes are monitored by CMS, the Centers for Medicare and Medicaid Services. They are based on theCPT Codes(Current Procedural Technology codes) developed by the American Medical Association.2HCPCS codes are regulated by HIPAA, which requires all healthcare organizations to use the standa...
Original Medicare (Part A and Part B) allows you to see any doctor you choose. However, not all providers handle billing in the same way. Medicare assignmentprovides a list of rates that Medicare will pay for the healthcare services it covers. If your provider participates in Medicare assignm...
Care clearly unrelated to the terminal illness continues to be covered by Medicare Parts A and B, with all normal rules applicable, e.g., co-payments, coverage guidelines and deductibles. VITAS Healthcare has been caring for advanced illness patients since 1978. As a Medicare-certif...
For self-pay Medicare bad debt, do providers bill the patient 90 or 120 days from the Medicare RA date? For cost reports starting on or after October 1, 2020, the provider has 120 days. Prior to that date, it was 90 days. When did the 120-day billing rule start versus the historica...
Survey Exposes Pervasive Billing Errors, Aggressive Tactics in US Health Insurance Giuliana Grossi Almost half of insured Americans report receiving unexpected medical bills, leading to financial strain and contributing to worsening health outcomes for many patients, The Commonwealth Fund report reveals. Jul...
On December 11, 2024, the Texas Health and Human Services Commission filed a complaint in the United States District Court for the Western District of Texas. The complaint seeks to block the enforcement of a May 9, 2014,...more This New Year, California Imposes Guardrails on the Use of AI...
Medicare Hospice Benefit & Physician BillingMedicare Part A covers hospice patient expenses and regulates how physicians bill for their services. For most eligible patients, Medicare pays for hospice 100 percent, including visits by a nurse, physician and other healthcare professionals, as well as ...
patients, and others who pretend to be one of these parties. Medicare or Medicaid fraud can include billing for services that weren't provided, performing unnecessary tests, and receiving benefits when you're not eligible. Combined, Medicare and Medicare fraud cost taxpayers more than $146.5 ...
PECOS (the Provider Enrollment, Chain, and Ownership System) is an online platform healthcare providers and suppliers use to submit and manage their Medicare enrollment information. This allows them to register to provide services for patients with Medicare. The only other option for these groups of...