It’s quite common for people to get perplexed while going for medical services provided by the CMS. What many medical service providers find confusing is dealing with Medicare’s incident to billing and split/shared services. ‘Incident to’ services are provided as part of physician’s personal professional More..
The Centers for Medicare & Medicaid Services (CMS) is moving aggressively to shift healthcare payments from the traditional volume-based fee-for service model towards value-based payment models, also called value based reimbursement (VBR). This shift is focused on reducing the cost of health care in the More..
Not long ago, two similar lawsuits based on out-of-network provider issues were contested in the Texas Federal Court. Both the cases included Humble Surgical Hospital as the defendant, which was accused of submitting inflated bills to the two insurance companies-Connecticut General Life Insurance Co. (Cigna) More..
Designing a product label, which is compliant with the current regulations of both the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA), is a long and complex process. Pharmaceutical companies are continually managing product-labeling documents such as Summaries of Product Characteristics More..
President-elect Donald Trump has variously proposed plans for healthcare policy reform aimed at the following changes: The repeal of Obamacare. Enhancing private insurance competitiveness by national control of insurance that will provide health insurance coverage and affordability. Controlling drug prices. Trump has a robust directive More..
The National Correct Coding Initiative (NCCI) was developed by the Center for Medicare and Medicaid Services (CMS) to promote national correct coding methodologies. The NCCI also aims at controlling improper coding, which leads to inappropriate payments in Medicare Part B claims. The coding policies of the CMS were More..
To maintain business continuity, the healthcare and pharmaceutical industries should comply with the best practice standards and the most current legislation throughout the lifecycle of their product(s). Regulatory inspections aim at conducting an activity to demonstrate that your company is operating in compliance with the More..
The U.S. Food and Drug Administration (FDA) introduced the new food labels on May 20, 2016 to include more details on sugar, Vitamin D and Potassium content. This will also change the way the ingredients are displayed on the label, including changes in the used More..
As podiatry medicine is quite different from other specialties, it is essential for billing professionals to know how to address the complexities in the field. Whether it be coding for a complicated foot surgery or for billing something routine. There is greater emphasis on claim More..
The Department of Health and Human Services (HHS) released the final rule of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), with comment period implementing the Quality Payment Program (QPP), which is a part of MACRA. QPP improves Medicare by putting the focus More..