Blog Posts by Author: Leigh Polk
Three Steps to Radiology MIPS Success
There are three critical steps to maximizing Medicare reimbursement by optimizing your MIPS score. But first, radiologists need to understand the 2022 MIPS changes and requirements that must be met to avoid the negative 9% payment adjustment for noncompliance and achieve a bonus.Physicians have two tracks to choose from under the CMS Quality Payment Program: MIPS and Advanced Alternative Payment...
Three Questions You Should Be Asking to Determine if the No Surprises Act Applies to You
How do the billing protections established under the No Surprises Act impact my group?This is what everyone is asking. It’s a very complex question that isn’t answered with a simple yes or no. However, listed below are three questions you should ask to determine if any of your services are impacted by the No Surprise Act legislation.* Is the...
No Surprises Act: Your Top Questions Answered - Part 2
This blog is part two of a blog series focusing on answering the most common questions regarding the No Surprises Act. View Part One, which focused on questions related to providing a good faith estimate and obtaining patient consent.The No Surprises Act (NSA) — which provides patient protections by addressing surprise billing and banning balance billing — has many people wondering which parts of...
United Healthcare Expanding Designated Diagnostic Provider Program to Imaging Providers
United Healthcare has launched the Designated Diagnostic Provider (DDP) program for laboratory and major imaging services. In 2021, the program was implemented for laboratory facilities and is now expanding to include major imaging services in 2022. According to United Healthcare, the program is designed to help improve member access to quality care and reduce member healthcare costs. As part of...
No Surprises Act: Your Top Questions Answered - Part 1
The No Surprises Act (NSA), which went into effect on January 1, has many providers scrambling. The No Surprises Act provided protections for patients who unknowingly receive care from an out-of-network provider by addressing surprise billing and banning balance billing. Implementing the requirements of the No Surprises Act will require a new level of coordination between providers, payors, and...
Preparing for the No Surprises Act: Learn How Your Billing Solution Can Help
Effective January 1, 2022, the No Surprises Act (NSA) established new federal protections against surprise medical bills and balance billing for services received from out-of-network providers. The Act applies to emergency and non-emergency services provided by all healthcare providers and all commercial health plans. The No Surprises Act is not applicable to Medicare and Medicaid programs,...
2022 MIPS Final Rule Changes and 8 Key Takeaways for Pathology Practices
Based on their practice size, specialty, location, or patient population, clinicians have two tracks to choose from in the CMS Quality Payment Program: Participants who qualify as Advanced APM participants receive a 5% incentive for achieving threshold levels of payments and patients. All other eligible clinicians are required to participate under...
2022 PAMA Reporting Requirements and Reimbursement Cuts Will Impact Hospital and Independent Labs
Update 1/4/2022: Since the publication of this blog, legislation was passed to halt the 2022 reimbursement cuts and reporting requirements. Visit XIFIN’s PAMA Headquarters to view the revised PAMA schedule. After two years of PAMA reporting delays and one year of 0% PAMA related fee cuts, applicable laboratories (including hospital outreach laboratories) need to start preparing for 2022 PAMA...
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