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Did you know that the April ICD-10-CM updates are already in effect? Find out more! https://bit.ly/3xnLz2b #ICD10 #medicalcoding #medicalpractices #healthcaretrainingleader #codingupdates

Did you know that the April ICD-10-CM updates are already in effect? Find out more! https://bit.ly/3xnLz2b #ICD10 #medicalcoding #medicalpractices #healthcaretrainingleader #codingupdates

Effective for dates of service on and after 8/12/2024, the following codes are being added to Medicare’s Prior Authorization List: L0631, L0637, L0639, L1843, L1845 and L1951. Failure to submit a prior authorization for these codes when delivery is expected on or after 8/12/2024 will result in an automatic denial and Medicare does not allow for retroactive authorizations. #oandp #industrypsa #priorauthchanges #detailsmatter #complianceauditworthy #stayinformed O&P Insight can provide detailed compliance reviews of medical records for all items that require prior authorization in an effort to minimize the potential for a non-approved prior authorization. Reach out today (725) 238-2008.

With claims becoming more difficult due to delays in accessing medical professionals and the increasing involvement of reinsurers, the complexity has grown. Bruno highlights the importance of obtaining relevant medical information and the impact of these challenges on client experiences. Learn how AFRM is tackling these issues to ensure clients receive the best support possible. #InsuranceClaims #ClientSupport #AFRM #ClaimsManagement

On Wednesday, June 5, at 12 pm ET, Press Ganey will host the webinar "Navigating the OAS CAHPS Mandate," where regulatory experts will discuss how to prepare for the mandatory #OASCAHPS Survey. The webinar will go over the immediate next steps leading up to the mandatory reporting period, key considerations for choosing a vendor and what you can do to prepare now to avoid financial penalties. #Medicare #ASC

https://lnkd.in/e6Perik6 Per CMS, "effective January 1, 2024, providers and suppliers should no longer include AUC consultation information on Medicare FFS claims. However, claims containing AUC-related codes with dates of service in 2023 and 2024 will continue to process." - CMS is "instructing the MACs and SSMs to not reject or return advanced diagnostic imaging claims to providers with dates of service from January 1, 2024 ─ December 31, 2024, simply because an AUC Program G code or modifiers are submitted along with the advanced diagnostic imaging HCPCS procedure code." - Make sure your billing teams are aware of the new CMS CR 13485.

On May 3, Centers for Medicare & Medicaid Services (CMS) issued draft guidance on the #Medicare Drug Price Negotiation Program for #IPAY 2027 and Manufacturer Effectuation of the Maximum Fair Price in 2026 and 2027. This draft guidance includes revisions to previous guidances, in addition to introducing new details on MFP effectuation and MFP amounts. Our #ADVIExperts summarize this new guidance in our most recent #ADVIInstant*: https://lnkd.in/emtK_GRq *This is a delayed release. ADVI Instant content is distributed in real-time for ADVI retainer clients.

The ICD-10 updates for 2025 are now effective! How did the implementation go for your team this year? Did you know that many Health Plans spend from 4 to 8 weeks just analyzing how the update will impact them before they begin configuring their systems with the new codes? Our solution takes that analysis time down to days, if not hours, and ensures data quality that helps improve 1st pass adjudication rates. Let's set up a call! https://gag.gl/NkgSP8

DID YOU KNOW? HBMA Members are able to access lists of members and appear on a list of medical billers in several ways. The RFI Tool allows a practice to provide information about their practice, and the tool will match them to an HBMA member or members who align with the profile. This tool will request information about specialties, number of providers, how billing functions are currently provided, monthly claims, and more. Once the profile is completed, our system will calculate matches based on the practice's answers. HBMA members that match will have an opportunity to reach out to the practice directly or to have them contact you. #HBMA #memberbenefits #RCM #membersonly #billingcompanies https://buff.ly/3thnR5G

Have you ever wondered how a Medical Cost Projection (MCP) works? 🤔 An MCP Report is a comprehensive and affordable projection of an injured person's future medical costs. It can be an effective tool for setting reserves, helping advance negotiations to achieve a settlement, and auditing existing files. Our experienced Medical Direction Experts will closely review your medical records to determine the reasonable type, amount, and cost of future medical care based on the information provided. Get your expert assessment now! ⬇️ https://lnkd.in/eSNfhhpV #MDData #MedicalCostProjection #MCPReport #ExpertAssessment