Xavier Becerra, Secretary of the U.S. Department of Health and Human Services (HHS) recently informed the House Appropriations Committee that he would be seeking feedback from stakeholders before enacting a policy to end surprise billing although he … [Read more...] about Will the No Surprises Act be Implemented as Lawmakers Intended?
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Verify Changes to CPT Codes for Breast Reconstruction Claims
If your practice is experiencing an increase in denials or reimbursement delays from payors for breast reconstruction claims, it may be worth revisiting the CMS’s updates to the breast reconstruction codes that went into effect January 1, 2021. For a … [Read more...] about Verify Changes to CPT Codes for Breast Reconstruction Claims
Out-of-Network Arbitrations Yield Favorable Results For Providers
The New Jersey Department of Banking and Insurance (‘DOBI’) has published statistics tracking the number of Surprise Bill cases submitted to Maximus Federal, the DOBI contractor handling arbitration cases under the New Jersey Out-of-Network Consumer … [Read more...] about Out-of-Network Arbitrations Yield Favorable Results For Providers
Elective surgeries may have been ceased, but plastic surgeons are not resting amid coronavirus pandemic
During these unprecedented times, many elective surgeries have been suspended to allow for COVID-19 patients to receive necessary care in their time of need. This has halted most plastic surgeries for the time being, but plastic surgeons are not … [Read more...] about Elective surgeries may have been ceased, but plastic surgeons are not resting amid coronavirus pandemic
Reimbursement Benchmarks Will Exacerbate Surprise Billing Problem
On Friday, March 6th, Modern Healthcare published an article by Dr. William Jaquis, President of the American College of Emergency Physicians, discussing how narrow networks and high-deductible health plans are the true root causes of surprise bills. … [Read more...] about Reimbursement Benchmarks Will Exacerbate Surprise Billing Problem
“Have PPO Networks Perpetrated The Greatest Heist In American History?”
The article below speaks to the rise of the PPO networks and the impact on the US healthcare system. While the article was published in 2016, the industry remains plagued with the same issues. The analogy of the healthcare players (hospitals, … [Read more...] about “Have PPO Networks Perpetrated The Greatest Heist In American History?”
NJ Surprise Bill Regulatory Alert — DOBI Publishes Implementation Bulletin
On November 20, 2018, The New Jersey Department of Banking and Insurance (“DOBI”) released Bulletin No. 18-14 (the “Bulletin”) relating to Implementation of P.L. 2018 C. 32 (N.J.S.A. 26:2SS-1 to -20) Out-of-Network Consumer Protection, Transparency, … [Read more...] about NJ Surprise Bill Regulatory Alert — DOBI Publishes Implementation Bulletin
Leslie Howard Speaks At The NJDPA Practice Enhancement Seminar
The conference room of the APA Hotel in Woodbridge was filled to capacity Monday, June 11, for the New Jersey Doctor-Patient Alliance Practice Enhancement Seminar focusing on what independent providers should do to prepare for the uncertainty coming … [Read more...] about Leslie Howard Speaks At The NJDPA Practice Enhancement Seminar