Medisys Compliance

FEBRUARY 16, 2025

Programs like MIPS (Merit-based Incentive Payment System), APMs (Advanced Alternative Payment Models), HEDIS (Healthcare Effectiveness Data and Information Set), and MACRA (Medicare Access and CHIP Reauthorization Act), each with specific metrics and reporting requirements, directly impact billing and reimbursements.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Patient Satisfaction Payment Systems 59

Medisys Compliance

MARCH 14, 2023

Wound Care Reimbursements in Various Healthcare Settings Inpatient Hospital Wound care in an inpatient hospital setting is reimbursed through the Diagnosis-Related Group (DRG) payment system. The MPFS is a payment system that reimburses healthcare providers for services rendered to Medicare patients in an outpatient setting.

Payment Systems 52

Payment Systems Medical Billing Medicare Medicare 52

Medisys Compliance

AUGUST 4, 2022

Proposed ESRD Payment System. This rule also proposes an update to the Acute Kidney Injury (AKI) dialysis payment rate for renal dialysis services furnished by ESRD facilities for calendar year (CY) 2023.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Payment Systems Medicare 59

Medisys Compliance

FEBRUARY 9, 2024

Providers should consult the latest CPT manual and coding resources to ensure they are using the correct codes for their services. Hospital Outpatient Prospective Payment System (OPPS) Updates OPPS is a payment system used by Medicare to reimburse hospitals for outpatient services, including some wound care procedures.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

Medisys Compliance

APRIL 25, 2024

MACRA replaced the previously used Sustainable Growth Rate (SGR) formula for Medicare physician payments. Advanced Alternative Payment Models (APMs): These models encourage collaboration between providers and offer the potential for higher shared savings if specific quality and cost goals are met.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Medicare Medicare 64

Medisys Compliance

JUNE 20, 2022

If a patient receiving home infusion therapy is also under a home health plan of care and receives a visit that is unrelated to the administration of the home infusion drug, then payment for the home health visit would be covered under the Home Health Prospective Payment System (HH PPS) and billed on the home health claim.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Medisys Compliance

JULY 11, 2024

Regular Audits and Reviews: Regularly audit your billing practices to identify any coding inconsistencies or missed opportunities. Understanding Reimbursement Models Outpatient Prospective Payment System (OPPS): This model assigns Ambulatory Payment Classifications (APCs) to specific wound care procedures, determining the reimbursement rate.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Payment Systems Medical Billing Services 59