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Fathom Secures $46M for AI Medical Coding Automation Platform

HIT Consultant

Founded in 2017, Fathom is the nation’s leading medical coding automation platform, an AI solution that fuses the best of deep learning and Natural Language Processing (NLP) to automate medical coding with unprecedented accuracy and efficiency. The Series B round brings Fathom’s total funding to $61M. AI for Medical Coding.

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Claims Software Can Ease Manual Processes Related to Treating Medical Tourists from Outside the U.S.

Healthcare IT Today

However, a 2017 survey lists medical tourism as an $11 billion business. On the receiver side, XML, JSON files, or spreadsheet formats can be easily ingested into payment systems and parsed by patient, by procedure, or by other metrics. But the U.S. has been named the top worldwide medical tourism destination.

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Supreme Court Saves Hospitals from $1.6B Cut to 340B Program

Healthcare Law Blog

HHS’ move to reduce 340B drug reimbursement originated in 2017, when it issued a final rule reducing hospital reimbursement under the 340B Program for 2018 from 6% over each drug’s average sales price to 22.5% below the average sales price, resulting in a total reimbursement reduction of $1.6

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Quality Payment Program (QPP) Year 1 Performance Results

CMS.gov

Quality Payment Program (QPP) Year 1 Performance Results. Earlier this year, we released preliminary participation data on clinicians eligible to participate in the Merit-based Incentive Payment System (MIPS) under the Quality Payment Program (QPP).

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Optimizing MIPS Value Pathways (MVPs) for Oncology Practices in 2025

HIT Consultant

The MVP framework was designed to ease the burden imposed on clinicians and their administrators who participate in the MIPS program.

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CMS Issues Long-Awaited Medicare Advantage RADV Final Rule

Healthcare Law Blog

The Final Rule implements the following changes: CMS will extrapolate RADV audit findings beginning with payment year (“PY”) 2018 and will not extrapolate RADV audit findings for PYs 2011 through 2017. CMS will not apply a Fee-For-Service (“FFS”) Adjuster in RADV audits.

Medicare 105
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Uncompensated Care and DSH (Medicare disproportionate share hospitals)

AIHC

This estimate of total uncompensated care payments reflects CMS Office of the Actuary’s projections that incorporate the estimated impact of the COVID-19 pandemic. LTCHs are paid under the Long-Term Care Hospital Prospective Payment System (LTCH PPS). The FY 2022 IPPS and LTCH PPS final rule will be issued in multiple parts.