DrKumo Remote Patient Monitoring

FEBRUARY 14, 2023

The Centers for Medicare and Medicaid Services (CMS) has assigned Current Procedural Terminology (CPT) codes for RPM, which cover both acute and chronic diseases. Acute Disease Examples Acute diseases can come on suddenly and range from minor to severe conditions.

HIPAA 40

HIPAA Medicare Health Data 40

Connected Health Initiative

FEBRUARY 27, 2023

Under current law, Medicare is generally not able to pay for live audio and video doctor visits. Examples include the Telehealth Modernization Act of 2021 (H.R. That means ensuring Medicare patients can access the same types of care as patients with private insurance. 4040, 117th, as introduced).

Digital Health 52

Digital Health Medicare Telehealth Connected Health 52

FierceHealthIT

NOVEMBER 21, 2023

Legacy Medical Consultants, a wound care manufacturer, is under fire for its business practices that critics say are another example of companies in the industry exploiting the Medicare system. |

Medicare 115

Medicare 115

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

Health Populi

JULY 11, 2019

Today’s example of this is Clover Health, which launched Clover Therapeutics this week. This research organization will develop medicines targeting older adults — which makes sense because Clover Health’s target consumer market is Medicare Advantage beneficiaries. Xellia, FYI, is based in Denmark.

Life Science 220

Life Science BioTech Medicare Pharmaceuticals 220

BHM Healthcare Solutions

APRIL 2, 2019

Editor’s Note: Medicare Advantage organizations (MAOs) continue to do a poor job of maintaining accurate provider directories—and it’s landing some in hot water with the federal government. CMS issued a final rule April 1 to update 2020 payment policies for Medicare Advantage and Part D prescription drug plans.

Medicare 40

Medicare 40

Healthcare IT News - Telehealth

FEBRUARY 5, 2020

The Center for Connected Health Policy has published a 21-page guide intended to help providers with telehealth-based Medicare and Medicaid reimbursements. WHY IT MATTERS.

Telehealth 154

Telehealth Medicare Primary Care Health Policy 154

Health Populi

FEBRUARY 4, 2024

Retail health-meets-Medicare. This work started in 2023 involving Walmart Health clinics serving Medicare members and looking to partner with UnitedHealth plan members and others. The examples of collaborations and alliances described here have been just a toe in much deeper water that’s the evolving health/care ecosystem.

Primary Care 212

Primary Care Medicare Medical Billing Public Health 212

BHM Healthcare Solutions

OCTOBER 2, 2018

Editor’s Note: Medicare Advantage organizations (MAOs) continue to do a poor job of maintaining accurate provider directories—and it’s landing some in hot water with the federal government. The OIG’s report, released in September, found Medicare Advantage organizations overturned about 216,000 denials annually during the period.

Medicare 40

Medicare 40

Health Populi

APRIL 8, 2019

That retirement cost gap is the sticker-shock assumption that Medicare is going to cover all health care expenses in retirement. The $285K also assumes the couple doesn’t have employer-sponsored retiree health care coverage and qualifies for “Original Medicare” (not Medicare Advantage, for example).

Medicare 271

Medicare Nursing 271

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 93

Medicare RCM Private practice Nursing 93

BHM Healthcare Solutions

MAY 1, 2018

Payers are rapidly becoming educated in telehealth and are keen on closing telehealth gap, but need to be mindful of Medicare requirements. Almost a third of telemedicine claims sampled by HHS’ Office of Inspector General did not meet Medicare requirements, resulting in an estimated $3.7

Medicare 40

Medicare Telehealth Telemedicine 40

Healthcare IT Today

MAY 5, 2023

The following is a guest article by Erin Rutzler, Vice President of Fraud, Waste, and Abuse at Cotiviti In Delaware, more than 250 Medicare patients underwent unnecessary genetic testing based on telehealth consultations that often lasted less than two minutes— costing Medicare thousands of dollars per patient.

Medicare 62

Medicare Telehealth Healthcare IT Health IT 62

South Central Telehealth Resource Center

MAY 24, 2018

Q: Per Medicare regulations, do the providers at a distant site have to be hospital-based or can they be in a private setting – for example, a group of pulmonologists who want to create a telehealth system on their own? Also, all telehealth services must meet the Medicare established set of criteria for reimbursement.

Medicare 48

Medicare Nursing Telehealth Health Policy 48

Health Populi

SEPTEMBER 20, 2021

You’ll find Best Buy Health here, 1-800-Contacts, and Hims, for example. Hy-Vee also introduced a Medicare Aisle into its grocery stores in August 2021. It’s not just the prototypical suspects who you might expect, such as Amwell, Teladoc, and Zipnosis. Their core businesses cover, respectively, Retail consumer electronics.

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Telehealth General practice Primary Care Medicare 322

Healthcare IT Today

DECEMBER 28, 2022

For example, a piece in the Chicago Tribune recently outlined a growing movement among hospitals in its region to begin charging for patient requests made through portals such as Epic’s MyChart. More recently, however, providers have begun to reevaluate their position on charging for medical advice requested via a portal.

Medicare 81

Medicare EHR Telehealth Patient Experience 81

Health Populi

AUGUST 24, 2021

As an important example, the COVID-19 pandemic has demonstrated that, for instance, despite widespread availability of free vaccines, there are continued inequities in vaccine coverage, which perpetuates COVID-19–related health inequities. This research looked at enrollment in Medicare Advantage plans compared with traditional Medicare.

Primary Care 334

Primary Care Medicare Nursing Public Health 334

Health Populi

MARCH 9, 2022

For those of you focused on serving Medicare or older patients, there are some important findings in the JLL study to add into your scenario planning assumptions. Those often lead to follow-up care, so we may not be seeing any difference between in-person and telehealth for follow up to specialists, etc.,” ” she added.

Telehealth 227

Telehealth Medicare Life Science Mental health 227

Health Populi

JUNE 1, 2021

We can look to Medicare Advantage programs in the current landscape of health care payment: these plans and “payviders” have an incentive to adopt useful tech that helps people care for themselves at home and on-the-go, and there are examples of plans doing just that.

Digital Health 332

Digital Health Medicare Telemedicine Health Technology 332

Health Populi

MARCH 12, 2020

A couple of intriguing examples: Ali Health, part of Alibaba (the e-commerce giant), launched a free online clinic in locked-down Hubei (whose capital is Wuhan) where in five days, 100,000 patients received remote consultations. Check out this last public health poster about Medicare and COVID-19. No, it’s not from the U.S.

Telehealth 292

Telehealth Medicare Telemedicine Public Health 292

TheraNest

MARCH 12, 2024

4. Direct Medicare Billing for Mental Health Counselors and Marriage and Family Therapists Beginning this year, mental health counselors (MHCs) and marriage and family therapists (MFTs) can bill Medicare under Part B coverage for their services allowed by the PFS.

Medicare 52

Medicare Telehealth Mental health 52

Healthcare IT News - Telehealth

JANUARY 11, 2023

KFF's survey of state Medicaid programs found them not only expanding telehealth benefits – for example, providing audio-only coverage of behavioral health services , group therapy and medication-assisted treatment – but also adding several provider types, researchers said in the issue brief. WHY IT MATTERS.

Telehealth 139

Telehealth Medicare Healthcare IT Public Health 139

Aging in Place Technology Watch

JANUARY 4, 2023

And some of the ‘ best’ examples are posted. For example, asking ChatGPT “ how is a nursing home paid for ”, the answer was detailed and accurate about the six ways to pay for the care (see below). Medicare: Medicare is a government health insurance program for people over 65 and for certain younger people with disabilities.

Nursing 122

Nursing Medicare 122

Healthcare IT News - Telehealth

MARCH 25, 2024

The Centers for Medicare and Medicaid Services just released data on its Acute Hospital Care at Home initiative , which thus far has admitted 11,159 patients suffering from respiratory infections, heart failure and severe sepsis. This optimizes resource allocation and reduces the burden on healthcare workers for frequent in-person visits.

Digital Health 165

Digital Health Patient Experience Healthcare IT Nursing 165

CMS.gov

OCTOBER 2, 2018

Modernizing Medicare to Take Advantage of the Latest Technologies. Administrator, Centers for Medicare & Medicaid Services. Modernizing Medicare to Take Advantage of the Latest Technologies. However, while medical technology is developing at a rapid pace, Medicare’s payment systems haven’t always been as quick to change.

Medicare 44

Medicare Medical Technology Health Information Health Data 44

Healthcare IT News - Telehealth

JANUARY 23, 2023

For example, the U.S. government passed the Advancing Telehealth Beyond COVID-19 Act of 2022, which allows Medicare patients access to telehealth services, including audio-only services, through 2024. Further, telehealth services are becoming more accessible, which is driving greater adoption.

Telemedicine 200

Telemedicine Telehealth Patient Experience Mental health 200

Healthcare IT Today

JULY 14, 2022

For example, an AI-powered system to predict the likelihood of hospitalization to avoid in-patient admission can help target interventions, prevent adverse outcomes, and reduce healthcare costs. Here are three examples of biases to look out for in AI solutions and how to curtail or prevent them altogether. Inadequate data.

Medicare 122

Medicare Health Data Healthcare IT Leadership 122

Healthcare IT News - Telehealth

FEBRUARY 15, 2023

In the past, many of these innovations were limited in coverage and use to Medicare seniors. "One of the most obvious and tangible examples of this is technology that detects elevated blood-glucose levels, a red flag for prediabetes or diabetes. Several examples come to mind here. Today they’re used much more broadly.

Health Technology 199

Health Technology Primary Care Telehealth Healthcare IT 199

Telebehavioral Health Institute

MARCH 9, 2023

Private payers, Medicaid, and Medicare initiated widespread telehealth reimbursement approvals. The article below clarifies and summarizes the end-of-pandemic reimbursement decisions made by private payers, Medicare, and Medicaid. Medicare Advantage plans may offer additional telehealth benefits.

Telehealth 119

Telehealth Medicare Remote care Public Health 119

Healthcare IT Today

JUNE 21, 2023

Inflation will push Payers back into the Public Marketplace whether Statewide and Federal Health Exchanges, Medicaid and Medicare Before the pandemic, many payers left statewide health exchanges as they found more ways to become profitable outside of the public market.

Medicare 62

Medicare FHIR Healthcare Improvement EHR 62

TheraNest

FEBRUARY 22, 2021

A large portion of mental health organizations submit claims to Medicare on a regular basis. The 8-minute rule for therapy is a time-coded stipulation that allows providers to bill Medicare insurance payers for one billing unit of service. What is the 8 Minute Rule for therapy billing? 30 minutes divided by 15 equals 2 billable units.

Medicare 105

Medicare Mental health 105

Healthcare IT News - Telehealth

MAY 30, 2023

Some of those expansive measures, like expanded Medicare reimbursement for telehealth, will remain, at least temporarily, and others, like continuous Medicaid enrollment, will be phased out entirely in the next few months. What does the end of the PHE mean for the future of telemedicine?

Telemedicine 183

Telemedicine Medicare Telehealth Public Health 183

BHM Healthcare Solutions

NOVEMBER 10, 2022

For Medicare plans providing health coverage, such as Medicare Advantage or Medicare Cost plans, each plan is given an overall summary rating based on how it performs across five main categories: Chronic conditions management. Plus, consumers can see the scores while shopping for insurance plans.

Medicare 52

Medicare Patient Experience Public Health 52

Connected Health Initiative

JUNE 2, 2023

For example, RPM and RTM are both subject to the 20 percent copay required for Medicare coverage. Many Medicare beneficiaries are unable to afford a monthly bill for remote monitoring, even if it may greatly benefit their health.

Medicare 52

Medicare Digital Health Connected Health Nursing 52

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

CMS.gov

NOVEMBER 16, 2018

Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report. Director, Medicare-Medicaid Coordination Office, Topic. Medicare Parts A & B. Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report. Jeremy.Booth@c…. Fri, 11/16/2018 - 18:51.

Medicare 35

Medicare 35

Continue Education Journal

DECEMBER 30, 2021

These public programs include Medicare, the ACA, federal employee insurance, VA insurance, and more. For example, chronic conditions would only need to be authorized every year instead of every month, lowering the administrative cost. With the majority of payers in the U.S.

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Interoperability Health Information EMR Medicare 246