Telebehavioral Health Institute

JANUARY 12, 2023

In January 2023, the Centers for Medicare & Medicaid Services (CMS) rolled out a new telehealth “indicator” to make information about Medicare telehealth providers on publically-available clinician profile pages more readily available. Medicare Telemedicine Snapshot Data File. 2021 (2021). 2021 (2021).

Medicare 52

Medicare Telehealth Telemedicine Public Health 52

DrKumo Remote Patient Monitoring

MARCH 29, 2023

The Medicare 8-Minute Rule is a critical component of billing for physical therapy services. In this article, we will provide a comprehensive overview of the Medicare 8-Minute Rule for Physical Therapy. Medicare adds up the total number of units charged to calculate the final payment amount.

Medicare 40

Medicare HIPAA Telemedicine 40

DrKumo Remote Patient Monitoring

JANUARY 6, 2024

Beginning January 1, 2024, a significant change in Medicare billing practices greatly impacted Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). For the first time, these centers can bill Medicare separately for Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) services.

Medicare 40

Medicare Telehealth Digital Health Remote care 40

Healthcare IT News - Telehealth

NOVEMBER 10, 2020

Prepare Now for Anticipated Changes to Medicare and Private Payer Rules. The Centers for Medicare and Medicaid Services (CMS) is expected to issue new rules for telehealth in the release 2021 Physician Fee Schedule later this year. Today, Medicare reimburses for specific services when delivered via live video.

Public Health 141

Public Health Medicare Telehealth Health Policy 141

Health Populi

FEBRUARY 27, 2024

The aspirational document sets out the mission that “every individual deserves the right to obtain health care that is comprehensive, equitable and compassionate.” Kudos to NABIP for developing this document and taking a leadership position in supporting health care as a civil right for all consumers, emerging as health citizens, in America.

HIPAA 340

HIPAA Public Health Leadership Mental health 340

Mobi Health News

JULY 16, 2018

The "historic changes" announced late yesterday by the Centers for Medicare & Medicaid Services, promising big adjustments to its policies around the Physician Fee Schedule and the Quality Payment Program, already have the healthcare industry talking.

Interoperability 133

Interoperability EHR Medicare 133

Mobi Health News

JULY 16, 2018

The "historic changes" announced late yesterday by the Centers for Medicare & Medicaid Services, promising big adjustments to its policies around the Physician Fee Schedule and the Quality Payment Program, already have the healthcare industry talking.

Interoperability 121

Interoperability Medicare Telehealth 121

Healthcare IT Today

JANUARY 17, 2024

Many include tight deadlines for initial response and appeals and have substantially greater Audit Documentation Request (ADR) letters that in some cases exceed 100 pages. Higher denial rates and increasing audit demands underscore the need for operational efficiency in billing, coding, and clinical documentation to enhance profitability.

Medicare 102

Medicare Health IT Healthcare IT Leadership 102

FierceHealthIT

SEPTEMBER 19, 2018

Recovery audit contractors (RACs) returned $214 million to the Medicare program in fiscal year 2016. of Medicare expenditures, and one organization says the program is hampered by limits on documentation requests. But that represents less than 0.1%

Medicare 60

Medicare 60

DrKumo Remote Patient Monitoring

FEBRUARY 4, 2024

The 2024 Medicare Physician Fee Schedule (PFS) Final Rule, set forth by the Centers for Medicare & Medicaid Services (CMS), brings pivotal updates in healthcare reimbursement. This article aims to provide a comprehensive understanding of these changes, which are crucial for healthcare providers.

Medicare 40

Medicare Telehealth Mental health Digital Health 40

Healthcare IT News - Telehealth

MAY 13, 2022

As outlined in court documents , marketers identified Medicare and TRICARE beneficiaries to target for expensive medications – such as pain creams, scar creams, eczema creams and migraine medication – and durable medical equipment, including wrist, shoulder, knee and ankle braces. " WHY IT MATTERS. ON THE RECORD.

Telehealth 147

Telehealth Medicare Federal healthcare Healthcare IT 147

FierceHealthIT

AUGUST 21, 2018

The Department of Justice is asking a court to compel Anthem to release testimony pertaining to a Medicare Advantage fraud investigation and the insurer's use of retrospective chart reviews. Court documents also indicate federal prosecutors may be close to filing a complaint against the insurer.

Medicare 80

Medicare 80

DrKumo Remote Patient Monitoring

JANUARY 18, 2023

Medicare-approved Remote Patient Monitoring (RPM) has become an increasingly important aspect of healthcare delivery. Remote monitoring through telehealth services has enabled healthcare providers to provide more efficient and effective care to patients, especially those enrolled in Medicare and Medicaid Services.

Medicare 40

Medicare Telehealth 40

Healthcare IT Today

NOVEMBER 22, 2022

The number of Medicare TPEs and commercial payer take-back audits alone is skyrocketing. They also look to flag “items and services that have high national error rates and are a financial risk to Medicare.” Meanwhile, Medicare also has a Fee for Service Recovery Audit Program. Tricare and Medicare).

Medicare 91

Medicare RCM Private practice Nursing 91

Telebehavioral Health Institute

JANUARY 17, 2023

While the official end of the public health emergency (PHE) was extended to April 2023 for many federal government programs, two federal actions will further extend the deadline for federal Medicare reimbursement until at least December 31, 2024. Other repercussions of the end of the PHE include the return of HIPAA and licensure enforcement.

Public Health 98

Public Health HIPAA Mental health Medicare 98

Healthcare IT Today

MARCH 5, 2024

Rucker points out that the current data exchange standard in health care, the Trusted Exchange Framework and Common Agreement (TEFCA) , is “anchored on 1990s document exchange” and is useful for slow-moving bureaucratic decisions, not providing continuous access to data for improved health care.

FHIR 101

FHIR Interoperability Healthcare IT Medicare 101

Healthcare IT Today

JUNE 29, 2023

To avoid penalties, maximize revenue, and accurately document claims, ASCs must understand these changes. Medicare Certification ASCs must sign a contract with Medicare and meet its Conditions for Coverage (CFC) to be paid. ASCs must also meet Medicare’s Conditions for Coverage. Two other appendices apply to ASCs.

Medicare 52

Medicare Medical Billing HIPAA Medical Billing Services 52

Healthcare IT News - Telehealth

JANUARY 30, 2023

While it made "significant" changes to the Medicare Benefits Schedule (MBS), the expanded telehealth services were "only partly supported by sound implementation arrangements." " The audit found that it did not require key implementation decisions and plans to be documented.

Telehealth 140

Telehealth Psychiatry Medicare Health Policy 140

FierceHealthIT

NOVEMBER 5, 2019

Up in arms a year ago, physician groups found a lot to like in Medicare’s new approach to evaluation and management (E/M) services finalized in the 2020 physician fee schedule.

Medicare 66

Medicare 66

Healthcare IT News - Telehealth

FEBRUARY 22, 2021

Among the allegations are that Wolfe and her conspirators submitted well over $400 million in illegal durable medical equipment claims to Medicare and the Civilian Health and Medical Program of the Department of Veterans, relying on the guise of "telemedicine" to explain the unusually high volume of claims. THE LARGER TREND.

Telemedicine 184

Telemedicine Medicare Telehealth Healthcare IT 184

care innovations

MAY 16, 2018

Congress and the Centers for Medicare & Medicaid Services (CMS) have generated hope among health plans, insurers, providers and patients that Medicare telehealth reimbursement is set to expand significantly in the year ahead. The Rural Health Strategy & Medicare Telehealth Reimbursement.

Medicare 41

Medicare Telehealth Primary Care Telemedicine 41

Health Intersections

FEBRUARY 14, 2023

On Friday last week, an article by Wendy John was published by Wild Health , in which I’m quoted as saying, regarding the My Health Record and the Strengthening Medicare Taskforce report : FHIR guru Grahame Grieve has advocated for interoperability standards in healthcare for over two decades. If I did say exactly that I did not mean too.

FHIR 100

FHIR Medicare Digital Health Health Information 100

Healthcare IT News - Telehealth

SEPTEMBER 20, 2021

"We have seen all too often criminals who engage in health care fraud – stealing from taxpayers while jeopardizing the health of Medicare and Medicaid beneficiaries," said Deputy Inspector General for Investigations Gary L. More than $1.1 billion of that loss involved allegedly fraudulent claims related to telemedicine.

Telehealth 163

Telehealth Telemedicine Medicare Federal healthcare 163

Healthcare IT News - Telehealth

SEPTEMBER 13, 2021

Despite HHS instituting waivers making tele-ICU services payable under Medicare, RICU says it has been unable to expand its services to more hospitals – because the agency disallows payment for critical-care telemedicine if the physician is located outside the United States. hospitals via telemedicine, has sued the U.S.

Telehealth 111

Telehealth Medicare Telemedicine Healthcare IT 111

DrKumo Remote Patient Monitoring

APRIL 19, 2024

Understanding RPM Billing: Codes and Compliance RPM billing revolves around specific Current Procedural Terminology (CPT) codes established by Medicare and Medicaid. Mastering these codes and ensuring proper documentation are essential for maximizing reimbursement and justifying the implementation of RPM programs.

Health Data 52

Health Data Medicare 52

Healthcare IT Today

FEBRUARY 2, 2023

As proof, several health plans have been making headlines for coding errors and other issues that surfaced during audits: In just the third quarter of 2022, at least four audits have specifically targeted Medicare Advantage plans. The New York Times claimed eight of the 10 largest Medicare Advantage insurers had padded their bills.

Medicare 59

Medicare Leadership Healthcare IT 59

Telebehavioral Health Institute

JULY 13, 2022

See Medicare Telehealth Reimbursement: Act Introduced to Allow Counselors to be Reimbursed by Medicare and the heated discussion inspired in this TBHI Blog. Medicare plays a critical role in implementing these new behavioral health proposals, with almost $1 trillion in claims and providing benefits to more than 63 million Americans.

Medicare 52

Medicare Mental health Telehealth Primary Care 52

Healthcare IT News - Telehealth

JULY 9, 2020

The Centers for Medicare and Medicaid Services has put together further detailed guidance for how healthcare providers should be documenting and reporting electronic clinical quality measures for telehealth encounters.

Telehealth 181

Telehealth Primary Care Interoperability Medicare 181

Healthcare IT Today

MARCH 5, 2024

Every year, close to $265B in claims made by US healthcare organizations are denied because of the way claims are coded on payor documentation and delayed submissions are two chief reasons for the denials. RapidClaims Launches from Stealth with $3.1M

Medicare 93

Medicare Health IT Healthcare IT 93

Telebehavioral Health Institute

JANUARY 26, 2023

In February of 2022, Telehealth.org alerted the professional community that expanding Medicare reimbursement for telehealth from the Centers for Medicare & Medicaid Services (CMS) for video and audio services included an unpopular requirement for in-person meetings for telebehavioral health.

Mental health 75

Mental health Telehealth Medicare Public Health 75

FierceHealthIT

JUNE 12, 2019

HHS recently released two documents that address the lack of reporting when it comes to incidents of abuse and neglect of Medicare beneficiaries in skilled nursing facilities (SNF).

Nursing 84

Nursing Medicare 84

Mend

JANUARY 31, 2024

In this series, we will navigate through the essential requirements outlined by the Protecting Access to Medicare Act (PAMA) to shed light on the path toward achieving CCBHC certification. A cornerstone of the staffing requirements is the completion and documentation of a community needs assessment along with a staffing plan.

Health Information 52

Health Information Medicare Patient Experience Telehealth 52

Healthcare IT Today

OCTOBER 12, 2023

The Centers for Medicare & Medicaid Services (CMS) have taken a bold step by mandating a standard for prior authorization. The standardization of documentation for prior authorization also enables physicians to submit requests within their familiar electronic medical record systems, reducing the burden on providers.

FHIR 94

FHIR Interoperability Medicare Healthcare IT 94

Healthcare IT News - Telehealth

OCTOBER 27, 2020

The Centers for Medicare and Medicaid Services announced earlier this month , for example, that it would add 11 virtual services to its reimbursement list during the COVID-19 public health emergency – following in the footsteps of its earlier flexibilities for virtual care.

Telehealth 192

Telehealth Medicare Primary Care Healthcare IT 192

Healthcare IT Today

AUGUST 28, 2023

This type of document will require not only top-notch billing tools but also new levels of contractual collaboration between separate provider entities. The AHA’s aim was to reduce unnecessary documentation and streamline the coding process. cut to physicians who treat the country’s most vulnerable patients through Medicare.

Healthcare IT 108

Healthcare IT Medicare Telemedicine EHR 108

Healthcare IT Today

SEPTEMBER 24, 2023

Medicare Advantage costs are 12% lower than similar beneficiaries covered under fee-for-service Medicare, according to research from Inovalon and Harvard Medical School. Data analytics platform Arcadia launched a point-of-care generative AI assistant to improve risk factor documentation.

Medical Billing 107

Medical Billing EHR Medicare BioTech 107

Healthcare IT News - Telehealth

APRIL 10, 2019

The illegal kickback scheme allegedly involved companies that received money in exchange for referral of Medicare beneficiaries by medical professionals for back, shoulder, wrist and knee braces that are medically unnecessary. WHY IT MATTERS. billion in losses. ON THE RECORD. WHAT ELSE TO KNOW.

Telemedicine 156

Telemedicine Medicare Healthcare IT 156