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08/06/2018

The Trump administration’s reinstatement of risk-adjustment payments is a genuine benefit for the insurance exchanges created under the Affordable Care Act (ACA), aka Obamacare, whether that was the president’s primary motivation or not. But there are still big challenges waiting in the wings for the exchanges, which currently cover 11.8 million Americans.

08/06/2018

CMS’ 2019 Hospital Outpatient Prospective Payment System (OPPS) proposed rule introduces policies to reduce reimbursement for hospital outpatient clinic visits at off-campus, provider-based departments (PBD) and expand last year’s payment reductions for drugs purchased under the 340B discount pricing program by nonexcepted PBDs.

08/06/2018

A huge embezzlement case in New York's Nassau County is a stark reminder that physician practices are likely targets for embezzlers, and many managers don’t make the simple adjustments that can prevent it from happening to them.

08/06/2018

Sharpen your venipuncture coding to ensure you’re not losing out on easy money in the bank for one of the most common services that practices perform.

08/06/2018

Many specialists who often report blood-draw code 36415 (Collection of venous blood by venipuncture) outperform their peers in a comparison of national denial rates, according to Medicare claims data from 2016, the latest year available.

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