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Medicare Advantage benefits expand as more seniors hop aboard

11/05/2018

The unfolding evolution of Medicare Advantage plans is creating a ripple effect on the way medical practices approach their patient encounters, resulting in small to potentially larger changes in ways of conducting business. As more patients flock to the public-private hybrids, practices must grapple with a new array of threats and opportunities.

CMS says new Part B drug plan would drop costs, but drug makers have to play along

11/05/2018

by: Roy Edroso

CMS says its new “International Pricing Index (IPI) model” test will lower prices for patients and increase provider surcharges on those drugs in some parts of the U.S. starting in 2020. But some experts are skeptical the model will work.

Unlock complex eligibility requirements for hepatitis screening, vaccines

11/05/2018

by: Richard Scott

Hone in on hepatitis screening and vaccine codes to ensure you’re meeting patient eligibility requirements and correctly reporting a range of Medicare-covered preventive services.

5 answers to common HIPAA questions asked by patients and practices

11/05/2018

by: Mary Brandt, MBA, RHIA, CHE, CHPS

Question: I work for a large company. I called out one day because my daughter was sick. Do I have to provide a doctor’s note to my employer when I wasn’t the actual patient? I’m not under my employer’s health plan.

If workers’ comp patient comes back, treat him as a ‘new’ patient

11/05/2018

by: Roy Edroso

Question: A patient is seen for an IME (independent medical examination) for a workers’ compensation case. The carrier then decides they want us to treat the patient. Is that next visit a "new patient" or "established patient" visit?

4 of 5 enrollees in Medicare Advantage plans that require prior authorizations

11/05/2018

by: Richard Scott

The growing wave of Medicare Advantage (MA) plans may increase the administrative time your practice spends chasing down prior authorizations, as the bulk of MA patients – about 80% – are in a plan that requires one for at least some services, according to new analysis from Kaiser Family Foundation (KFF).

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