The Home Health (HH) Grouper program has various data validity edits that make sure it uses consistent and accurate data when calculating payment groups on HH claims. Of these edits, currently only a principal diagnosis not assigned to a clinical group causes HH claims to be returned to the provider. Other principal diagnosis code errors aren’t returned to the provider. In some cases, this causes processing problems.
CY 2023 Medicare Deductible, Coinsurance & Premium Rates Update
Patients using covered Part A and Part B services may be subject to deductible and coinsurance requirements. Medicare subtracts an inpatient hospital deductible amount from the amount payable to the hospital for inpatient hospital services it provides in a spell of illness. When a patient gets such services for more than 60 days during a spell of illness, they’re responsible for a coinsurance amount equal to one-fourth of the inpatient hospital deductible for each day of days 61-90 spent in the hospital. A patient has 60 lifetime reserve days of coverage, which they may use after day 90 in a spell of illness. The coinsurance amount for these days is equal to one-half of the inpatient hospital deductible.
Cybersecurity and Medical Billing and Coding Services: What You Need to Know Today
Cybersecurity might not be the first thing you think of when you think of medical billing companies or medical coding solutions, but it’s highly related.
It’s Time to Focus on Your Own KPIs for Medical Billing Solutions
There are many great recommendations for key KPIs to focus on in evaluating your approach
Monkeypox & Smallpox Vaccines: Include Product Code on Claims
The U.S. Centers for Medicare & Medicaid Services (CMS) had announced in August 2022 to only bill for monkeypox & smallpox vaccine administration when you got the vaccine at no cost from the government. CMS has now clarified that the correct instructions are to include these 3 elements on your claim, even if you get the vaccine from the government for free:
