MiMedx’s Post

Prior authorization continues to be a significant challenge in healthcare, causing delays in care and increasing administrative burdens. While efforts to reform processes are underway, including automation and regulatory adjustments, patients and providers still face hurdles navigating these systems. The healthcare industry must strike a balance between cost controls and patient access. https://lnkd.in/gUzms-CZ How have prior authorizations impacted your practice? #priorauthorizations #optimization #BluByrd

CPT Code G2211, also known as the "Complex Patient Add-On Code," is designed to capture the additional time, effort, and resources required when a provider addresses complex care needs during an office or outpatient visit. Key Details: Purpose: G2211 accounts for the extra work beyond what is typically included in primary evaluation and management (E/M) services. Usage Criteria: It is used alongside standard E/M codes like 99202-99215 when managing complex cases. Medicare Policy: Medicare primarily reimburses this code, but private payers may have varying acceptance policies. Benefits: Encourages Comprehensive Care: Supports providers in delivering quality care to patients with intricate healthcare needs. Improves Reimbursement: Ensures providers are fairly compensated for the additional work involved in complex care. Documentation: Requires thorough documentation to justify its use. reimbursements.

In today’s complex healthcare landscape, staying ahead is key. If you're in rheumatology, navigating reimbursement changes and clinical advancements is crucial. Cardinal Health has your back with Rheumatology Next, a newsletter packed with insights to elevate your practice. Stay informed and empowered! #healthcare #rheumatology #privatepractice #unitedrheumatology #CardinalHealth #news #specialtynetworks

The Importance of Prescription Audits in Healthcare :- Prescription audits are essential for maintaining high standards of patient care, ensuring the appropriate use of medications, reducing healthcare costs, and minimizing risks associated with medication errors. These audits play a vital role in continuous quality improvement within healthcare settings. A prescription audit is a thorough, systematic process designed to assess whether medical prescriptions align with established standards of care, guidelines, and regulations. The primary goals of these audits include:- - Improve the quality of prescribing practices. - Ensure patient safety. - Promote the rational use of medications. - Reduce the cost of the treatment. Regular prescription audits not only enhance the quality of care but also contribute to the overall efficiency and effectiveness of healthcare systems. By prioritizing these audits, healthcare organizations can better safeguard patient health and optimize resource utilization. Source : https://lnkd.in/gSN4di8H

Medicare Open Enrollment season has arrived. Is your organization helping patients make informed decisions about their 2025 healthcare coverage? At Brown & Toland Physicians, we believe in empowering both patients and healthcare providers with clear, accessible information about Medicare Advantage options. Key considerations we encourage patients to evaluate: 📋 Network access to preferred physicians 💊 Prescription drug coverage 🏥 Hospital and specialty care options 🤝 Care coordination services 💡 Additional wellness benefits Interested in learning more? Visit our Medicare Advantage page to explore our resources before the December 7 deadline: https://hubs.la/Q02WlR4v0 Healthcare professionals: What questions do you hear most often during Open Enrollment season? #MedicareAdvantage #OpenEnrollment #Healthcare2025 #ValueBasedCare #BrownAndToland #HealthcareLeadership

Integrated care is becoming a primary focus for healthcare organizations, which means addressing the diverse needs of patients is more important than ever. Learn how CarelonRx views the role of pharmacy benefits managers (PBMs) in healthcare, and how they provide personalized support for patients. https://lnkd.in/ephX8iF5

Healthcare costs are skyrocketing. Value-based care helps lower costs for everyone: providers, payers, and patients. Hear what Tsion, a pharmacist at CHESS, has to say about why value-based care is so impactful.

Care Gaps: The Key to Unlocking Incentives Closing care gaps has a ripple effect on both patient outcomes and financial incentives. Here’s what’s at stake: - MIPS Measures: Hospital and ED admissions, along with care costs, directly impact your scores—up to 9% of Medicare revenue is on the line. - Payer Incentives: Many payers reward practices not only for closing care gaps but also for reducing hospital and ED admissions, with bonuses often exceeding $100 per patient. - Performance Metrics: Proactive care improves quality scores, strengthens payer relationships, and builds trust with patients. It’s not just about identifying gaps—it’s about addressing them strategically.

Done well, Advanced Primary Care Management (APCM) could be transformative for primary care physicians and their patients. With the launch of these new reimbursement codes in 2025, Medicare is truly paving the way for primary care physicians to invest in value-based care for fee-for-service patients. But don't blow the opportunity. A poorly-executed APCM launch will disrupt your operations and destabilize your finances. Worst of all, low-quality APCM will diminish the trust your patients have in your practice. You must have a thoughtful, comprehensive plan for your APCM program. In our latest article, Darshan Bachhawat challenges you to consider the important questions that should guide your APCM plan. #APCM #MedicareAPCM #primarycare #Phamily https://hubs.li/Q0332_0y0