Articles Tagged With: reimbursement
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Study: Pharmacist Prescribing of Contraceptives Not Working as Well as Intended
Although 20 states have passed policies to allow pharmacists to prescribe short-acting hormonal contraception, these services are not used much, new research suggests.
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Case Managers Could Use Z Codes More for Patient Care and QI
Case managers, providers, and health systems underuse ICD-10 Z codes eight years after they were introduced. These codes could provide a wealth of data to researchers and case management quality improvement projects. They still hold promise to be a way for providers to collect reimbursement for their work to help patients with their social determinants of health.
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HRSA Compliance Exposes Hospitals to Liability and Fines
The Health Resources and Services Administration program that reimbursed providers for COVID-19-related treatment for uninsured patients was instrumental in helping hospitals survive the pandemic without excessive financial losses. But the federal government is looking at how that money was obtained and whether it was spent properly.
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Biden Administration Cracking Down on Nursing Home Safety
The Biden administration is promising an effort to improve safety and quality of care in the nation’s nursing homes. The fact sheet foreshadows substantially stiffer oversight and harsher enforcement. -
Uncertainty Over Health Plan Coverage Affects EDs
Patients are right to worry about out-of-pocket costs or whether their health plan will cover the visit. An expert explains more about what this means for EDs and about the current state of reimbursement for ED visits.
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Underpayment Is Major Concern for EDs with New Surprise Billing Law
This landmark consumer protection took effect Jan. 1, but litigation from advocacy groups is pending as insurers are jockeying with providers for reimbursement rate advantages.
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The Basic Elements of Healthcare Reimbursement, Part 3
In this month’s issue, the conversation on healthcare reimbursement turns to the additional prospective payment systems found across the continuum of care. Prospective payment remains a way in which the Centers for Medicare & Medicaid Services can determine the rates for care based on predetermined amounts rather than on billing. The processes are similar to the use of the diagnosis-related groups in the acute care setting, with some differences.
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COVID-19-Specific Codes Can Maximize Reimbursement
As many hospitals continue managing COVID-19 patients, six new ICD-10 codes will help facilities obtain reimbursement.
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Controversial ‘Public Charge’ Rule Under Further Review
Scrutiny on DHS policy that targeted immigrants using government benefits such as Medicaid.
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Acupuncture as a Pain Management Alternative
The goal is to provide data that will convince payors to reimburse acupuncture treatment in the emergency environment, a stumbling block that has thus far prevented larger-scale implementation. Additionally, researchers hope their work leads to fewer unnecessary opioid prescriptions.