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How Predictive Analytics Tools Can Improve SDOH Outcome

Harold Gibson

Social Determinants Of Health (SDOH), is defined by CMS as “the range of environmental, social and economic factors that can impact health outcomes.” According to the Centers of Disease Control and Prevention (CDC), the conditions in which people work, live, and learn can impact a significant range of health risks and outcomes. Lack of resources, including poverty and distance to health care, can result in poor outcomes for lower-income brackets and other vulnerable populations.

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Top 3 Tips for Optimizing Medical Billing Service Processes

Patrick Dougherty

Many medical practices are finding themselves trying to recover financially after the devastating losses that came in 2020 and early 2021 with the COVID-19 pandemic. Practices faced significant volume and revenue losses while protecting their patients from the virus that killed thousands of people. The financial and clinical challenges were tough enough that some practices were left closing their doors.

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Topics: medical billing proceess

CMS Facing RPM Reimbursement Changes for 2022

Harold Gibson

Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM)

Back in December of 2020, the CMS adopted the 2021 Physician Fee Schedule Final Rule policies for proposed RTM coding additions that could allow non-physicians, such as physical therapists and nurses, to bill separately from physicians, as well as expand coverage to include certain therapies and procedures now in question. The rule’s intent is to further clarify the CMS’ position on interpreting monitoring requirements, building on earlier RPM guidance from healthcare professionals and telehealth and related organizations. While the September 13. 2021 deadline for submitting comments has just passed, the situation is worth watching for practices utilizing telehealth as well as medical billing companies.

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Topics: telehealth billing, RPM Billing, RTM Coding

CPT Codes Updated for COVID-19 Vaccines by AMA

Harold Gibson

Since the very first days of the COVID-19 pandemic, there have been a variety of CPT code changes to deal with the crisis. Now, there’s been a new update to the CPT code set by the American Medical Association regarding changes to the way that COVID-19 vaccines and booster shots — slated to begin rolling out soon — are billed. Not only do these updates include new CPT codes for the COVID-19 vaccine, but also a new code for a new Pfizer formulation of the vaccine, a formulation that moved to a tris-sucrose buffer in place of the original formulation’s phosphate buffer.

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Topics: COVID Coding, COVID-19 Coding

The Medicare Physician Fee Schedule Proposal – What You Need to Know

Harold Gibson

The Medicare Physician Fee Schedule proposed rule recently came out, and physician groups and individual providers are already calling it a “mixed bag” for practices. While the proposed rule definitely has some good policies in it, there are some concerning ones, too. It’s important to be informed on the coming proposed changes and make your voice heard if your practice has concerns.

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Topics: Medicare Physician Fee Schedule

About this blog

A place for physicians and other healthcare stakeholders to share and discover information about everything related to running efficient medical practices.

Established in 2002 by a group of physicians, we are a national provider of medical billing services to group practices, clinics, and individual physicians. We also specialize in provider credentialing, payer contract reviews, and medical coding for a wide range of clients - from solo practitioners to multi-site, multi-specialty practices.

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