Survey: Many Medicare beneficiaries fear receiving a surprise medical bill
FierceHealthIT
FEBRUARY 18, 2020
A majority of Medicare beneficiaries are worried about getting a surprise medical bill as Congress ponders how to handle the issue.
Seniors on Medicare Advantage less likely to have issues paying medical bills: CDC study
FierceHealthIT
FEBRUARY 13, 2020
A new CDC study found significant gaps between Medicare and MA beneficiaries in having issues paying medical bills.
Medical Billing 
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Can Your Organization Spot a Conflict Before It’s a Crisis?
How to Turn “Check-the-Box” Compliance Trainings Into Real Learning
Trending Sources
Patients Growing Health Consumer Muscles Expect Digital Services
Health Populi
OCTOBER 15, 2019
These study respondents had also visited a doctor or hospital and paid a medical bill in the past year. One-third of these patients had a health care bill go to collections in the past year, according to Cedar’s 2019 U.S. 50% want clearer, easier-to-understand medical bills.
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Think Quintuple Aim This Week at #HIMSS25
Health Populi
MARCH 3, 2025
The growth of wearable technology, need and desire for real-world evidence and patient feedback, and especially patients’ growing role in paying for health care (think: high deductibles, co-insurance, and the challenge of medical debt) all drive the need to enhance the health care experience for patients in consumer and retail grades.
Digital Health 177
177 
Chicago Social Worker Indicted for Telehealth Medical Billing Fraud
Telebehavioral Health Institute
JUNE 21, 2023
million for medical billing fraud from Medicare. The indictment alleges that the couple conspired with a social worker to submit false claims to Medicare, falsely stating that residents had received individual psychotherapy sessions lasting one hour. Medicare fraud, in particular, increases healthcare costs for everyone.
A Toyota RAV4 Hybrid, a Playground Set, or Healthcare for a Family of 4: What $35,119 Can Buy in 2025 According to Milliman
Health Populi
MAY 27, 2025
This could hit medical offices managing patient bill paying (e.g., revenue cycle management), consumer spending on prescription drugs and medicines that have been consumer-driven (such as the GLP1 category), and personal medical spending for elective kinds of surgeries, from sports to dermatology and aesthetics.
Medical Billing 177
177 
Fixing Medicare Advantage Payments
Healthcare IT Today
FEBRUARY 22, 2023
There’s widespread consensus that payments to Medicare Advantage Organizations (MAOs) are a mess. These programs, which care for more than 30 million of the nearly 64 million Medicare enrollees , operate on the cutting edge of health care and suffer serious problems in data collection and billing.
Medicare 113
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Come Together – A Health Policy Prescription from the Bipartisan Policy Center
Health Populi
FEBRUARY 6, 2020
isn’t repealing or replacing the Affordable Care Act or moving to a Medicare-for-All government-provided plan. Improving Medicare. modernizing the Stark Law and Anti-Kickback Statute, modifying Medicare Part D drug benefits to cap out-of-pocket spending, and other items), and to improve Medicaid. Improving Medicaid.
Health Policy 199
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Seeing Health/Care Everywhere at CES 2025: My Preview for #CES2025
Health Populi
DECEMBER 30, 2024
In another post for contextualizing #CES2025 for health, , Ill detail some of the barriers, obstacles, and concerns on health consumers minds related to the adoption and ongoing use of digital health technologies with Trust being an over-arching issue on peoples minds.
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U.S. Health Care in 2025 Requires Scenario Planning: The Uncertainties That Inspire DIY Healthcare
Health Populi
APRIL 14, 2025
twelve months ago: uncertainties about private/commercial insurance and employment-based health benefits, as well as uncertainties about Medicaid erosion, Medicare benefit access and enrollment, the status of NIH-funded and tracked clinical trials, and many other aspects of health care security play into these landscapes.
Medicare 177
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Job #1 for Next President: Reduce Health Care Costs – Commonwealth Fund & NBC News Poll
Health Populi
MARCH 2, 2020
Across the various types of personal health care spending, more Hispanic people and people earning less than $50,000 a year are concerned about medical costs. One-in-four people also sold personal items, like jewelry or furniture, to get cash for health spending.
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Most Americans Want the Federal Government to Ensure Healthcare for All
Health Populi
DECEMBER 6, 2018
In 2006, Medicare Part D launched, which may have boosted consumers’ faith in Federal healthcare programs. Gallup points out in its analysis that the government is already a major health care channeler and funder through Medicare and Medicaid. Most people in the U.S.
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From Evolution to Innovation, from Health Care to Health: How Health Plans With Collaborators Are Re-Defining the Industry
Health Populi
FEBRUARY 4, 2024
Furthermore, health plan members now see themselves as medical bill payers, seeking value and consumer-level services for their health insurance premium investment. Patients and health plan members continue evolving into medical bill payers, with their homes and budgets baked into the concept.
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Bonus Features – September 24, 2023 – 72 percent of patients say affordability is the biggest challenge for paying medical bills
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. Nearly three in four (72%) patients say affordability is the biggest challenge to paying larger healthcare bills , according to a survey from Cedar.
How to Discover Better Insurance Coverage, Together
Healthcare IT Today
FEBRUARY 23, 2023
Streamline the billing process The right RCM partner will help providers optimize revenue by creating faster, easier processes to identify insurance coverage. As Medicare Beneficiary Identifiers (MBIs) only relate to Medicare coverage, providers need tools that will go beyond MBIs and caps from payer searches.
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The Health Care Costs for Someone Retiring in 2024 in the U.S. Will Reach $165,000 – Fidelity’s 23rd Annual Update
Health Populi
AUGUST 12, 2024
Note a couple of key assumptions: again that there are no long-term care expenses in this $165,000 — and that this calculation assumes the retiree would enroll in Traditional Medicare (not Medicare Advantage). As we continue to educate our patients, our families, and indeed ourselves (if you live in the U.S.),
Medicare 177
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The Unbearable Heaviness of Inflation: Will Consumers’ Financial Stress Erode Their Health?
Health Populi
JUNE 23, 2022
An hour after the Morning Consult session, I brainstormed the topic of consumers-as-payers of medical bills and prescription drugs with GoodRx strategy leaders. billion savings that Medicare Part D could accrue if the program bought generic drugs at the prices offered through the Mark Cuban Cost Plus Drug Company.
Medical Billing 288
288 Chicago Social Worker Indicted for Telehealth Medical Billing Fraud
Telebehavioral Health Institute
JUNE 21, 2023
million for medical billing fraud from Medicare. The indictment alleges that the couple conspired with a social worker to submit false claims to Medicare, falsely stating that residents had received individual psychotherapy sessions lasting one hour. Medicare fraud, in particular, increases healthcare costs for everyone.
In the New Inflationary Era, Gas and Health Care Costs Top Household Budget Concerns
Health Populi
APRIL 4, 2022
About 3 in 5 people worry about unexpected medical bills, followed by one-half concerned about their home’s utility bills and grocery store spending. The cost of filling up a car’s gas tank ranked first among U.S. householder’s worries of household budget items among 71% of U.S. voters across political party.
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A Health Consumer Bill of Rights: Assuring Affordability, Access, Autonomy, and Equity
Health Populi
FEBRUARY 27, 2024
In addition to highlighting the Patient’s Bill of Rights, NABIP’s keynotes and general sessions will speak to similar topics being brainstormed at VIVE this week — including mental health, maternal health, pharmacy and prescription drugs (pricing, PBMs), population health, and Medicare and Medicaid innovations.
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Will Consumers Cross the Cost-and-Trust Chasm Between Prescription Drugs and Hospitals?
Health Populi
OCTOBER 28, 2019
84% of Americans told the Foundation that they were concerned about how much health care costs will affect them in the future, with 42% of patients saying they couldn’t afford to pay over $500 for an unexpected medical bill. Hospital costs contribute to rising medical costs to 49% of health consumers.
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Patients-As-Health Care Payers Define What a Digital Front Door Looks Like
Health Populi
JUNE 6, 2023
pre-care cost estimates that are accurate (personalized based on their own health insurance plans), payment plans for paying medical bills over time, digital payment options (think: Venmo meets medical bills), a multi-purpose portal, and mobile access for both administrative tasks and care — that is, virtual care/telehealth.
Medical Billing 156
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While Costs Are A Top Concern Among Most U.S. Patients, So Are Challenges of Poverty, Food, and Housing
Health Populi
OCTOBER 28, 2019
In addition to paying for “my” medical bills, most people in the U.S. also say that income inequality and inadequate social services significantly contribute to high medical spending for every health citizen in the nation. This year’s poll was conducted in September 2019 and included input from 2,001 U.S.
Medical Billing 136
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The 2023 Health Economy – The Evolving Primary Care and Retail Health Convergence Through Trilliant Health’s Lens
Health Populi
SEPTEMBER 27, 2023
healthcare spending, with curves moving up and to the right, and the Medicare Hospital Insurance Trust Fund moving into the opposite direction toward insolvency by 2033. adults saying inflation has made it harder to pay medical bills.
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In U.S. Health Care, It’s Still the Prices, Stupid – But Transparency and Consumer Behavior Aren’t Working As Planned
Health Populi
JANUARY 18, 2019
On the positive side of transparency, the Centers for Medicare and Medicaid Services mandated that health care providers must post prices online, the requirement discussed here on CMS’s website. As the Harvard Chan-POLITICO study points out, prescription drug costs are top-of-mind for health consumers in America.
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Seniors Satisfied With Medicare Supplemental Plan
BHM Healthcare Solutions
MARCH 5, 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. Seniors continue to be overwhelmingly satisfied with their Medicare supplemental insurance coverage.
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The Latest KFF Poll on Consumer Experiences with Health Insurance Speaks Volumes About Patients’ Administrative Burden
Health Populi
JUNE 26, 2023
Note that one-third of people enrolled in Medicare or employer-sponsored insurance (ESI) self-rationed care due to cost in the past year. The top reason people in the U.S.
Medical Billing 156
156 
Experian Health Acquires Wave HDC, Immediately Enabling Real-Time, Single Inquiry Insurance Discovery/Verification at the Point of Patient Registration
Healthcare IT Today
DECEMBER 22, 2023
Wave HDC offers several insurance “curators” including Coordination of Benefits, Eligibility, and Medicare Beneficiary Identifiers, and serves hospitals, laboratories, billing companies, and physician groups.
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Why health care costs are making consumers more afraid of medical bills than an actual illness
Henry Kotula
APRIL 24, 2018
Some 86 percent of those surveyed said they’re covered either through their employer, have insurance they purchased directly, or through government programs like Medicare and Medicaid. And 53 percent received a bill that was higher than they expected.
What Are The Current Regulatory Changes And Compliance Requirements That ASCs Need To Be Aware Of In Their Billing Practices?
Healthcare IT Today
JUNE 29, 2023
However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance. 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.
Medicare 52
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Turning Increased Ambulatory Volumes into Financial Strength: 4 Moves for RCM
Healthcare IT Today
OCTOBER 23, 2023
For example, as outpatient services such as infusions outpace projections , and as the Centers for Medicare & Medicaid Services open the door to more outpatient procedures by moving 11 procedures off its “inpatient only” list, ambulatory providers must have the financial strength to make the investments needed to support growth.
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120 Bonus Features – August 6, 2023 – 83% of hospitals are collecting SDoH data, 46% of hospitals planning to use large language models in the call center, and more
Healthcare IT Today
AUGUST 6, 2023
Partnerships Fintech company Cedar is working with Google Cloud to build AI-powered tools to hep patients understand medical bills. Chicago-based RUSH University System for Health chose Cadence for remote monitoring and virtual care for Medicare and Medicaid patients with chronic conditions.
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Understanding the ICD-10 Code for Chronic Obstructive Pulmonary Disease
DrKumo Remote Patient Monitoring
JANUARY 26, 2023
Properly utilizing COPD codes can help healthcare providers (HCPs) with medical billing and coding, leading to accurate claim submission and reimbursement for their services. Therefore, it is important for HCPs to use these codes correctly when coding their medical services. Tobacco dependence (code: F17.2)
Why Chronic Care Management is Essential for Healthcare Providers in 2024
DrKumo Remote Patient Monitoring
OCTOBER 16, 2024
The code can be billed monthly, as long as the chronic care management services meet the criteria outlined by Medicare. Complex CCM services, which typically require more time and resources, also have specific billing codes, allowing providers to receive reimbursement for more intensive care coordination efforts.
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Healthcare IT Regulations – What Needs to Be Added and What Needs to Be Removed
Healthcare IT Today
SEPTEMBER 19, 2023
I would continue to advance CMS’ directive that by 2030 all Medicare and the bulk of Medicaid beneficiaries be in care engagements governed under a value-based contract.
Healthcare IT 139
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What Is CPT Code 99457
DrKumo Remote Patient Monitoring
APRIL 24, 2024
” In the dynamic landscape of modern healthcare, staying abreast of the latest developments in medical billing and coding is paramount for healthcare providers seeking to optimize patient care delivery and revenue generation. Welcome to our comprehensive guide to “What Is CPT Code 99457.”
Medicare 40
40 
Getting Started with Telehealth
TheraNest
AUGUST 20, 2018
CCHPCA State Laws and Reimbursement Policies and their State Telehealth Laws and Reimbursement Policies PDF (April 2017) – This resource also you to stay up to date on all Telehealth laws, policies, regulations, and Medicare/Medicaid programs state by state. Understanding Telehealth Billing. Marketing Your Telehealth Service.
Telehealth 75
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Hospitals’ off-site fees draw lawmakers’ scrutiny
Henry Kotula
APRIL 14, 2023
[link] More than two years after Congress acted to shield patients from surprise medical bills , lawmakers are turning to another source of unexpected medical costs: the fees that hospitals tack on for services provided in clinics they own. Others could see the added cost reflected later in higher premiums and copays.
Why Alexa’s bedside manner is bad for health care
Lloyd Price
JUNE 8, 2019
In April, at Fortune’s Brainstorm Health conference in San Diego, Bruce Broussard, CEO of health insurer Humana, said he believes technology will help patients receive help during medical crises, citing the benefits of home monitoring and the ability of doctors’ visits to be conducted by video conference.
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MedEvolve’s Settlement: A Key Lesson in HIPAA Policy Involving HIPAA Business Associates
Telebehavioral Health Institute
JUNE 3, 2023
However, they are only covered entities if they transmit information electronically concerning a transaction for which HHS has adopted a standard, such as billing Health Plans. Insurance companies, HMOs, company health plans, and government programs like Medicare and Medicaid Health Care Clearinghouses.
HIPAA 52
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3 in 4 Insured Americans Worried About Medical Bills — Especially Women
Health Populi
DECEMBER 9, 2021
Both employees accessing employer-sponsored health care via the private sector and commercial insurance, as well as health citizens covered by public sector plans Medicare and Medicaid had concerns about medical bills. A little kindness goes a long way indeed.”
Medical Billing 194
194 
HIPAA Business Associates: Lessons Learned through MedEvolve’s Settlement
Telebehavioral Health Institute
JULY 11, 2023
However, they are only covered entities if they transmit information electronically concerning a transaction for which HHS has adopted a standard, such as billing Health Plans. Insurance companies, HMOs, company health plans, and government programs like Medicare and Medicaid Health Care Clearinghouses.
HIPAA 40
40 HIPAA Business Associates: Lessons Learned through MedEvolve’s Settlement
Telebehavioral Health Institute
JUNE 3, 2023
However, they are only covered entities if they transmit information electronically concerning a transaction for which HHS has adopted a standard, such as billing Health Plans. Insurance companies, HMOs, company health plans, and government programs like Medicare and Medicaid Health Care Clearinghouses.
HIPAA 40
40 
Getting Started with Telehealth
TheraNest
AUGUST 20, 2018
CCHPCA State Laws and Reimbursement Policies and their State Telehealth Laws and Reimbursement Policies PDF (April 2017) – This resource also you to stay up to date on all Telehealth laws, policies, regulations, and Medicare/Medicaid programs state by state. Understanding Telehealth Billing. Marketing Your Telehealth Service.
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