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Blog Posts by Tag: Regulatory

The Value of True Customer Advocacy

XIFIN Complaint to CMS Results in Modified Guidance on Health Plans’ Payment of Claims Customer advocacy is a core tenet of our business at XIFIN. While it’s easy for companies to say that customer-centricity and advocacy are core values, the proof is whether customers experience the value and impact of said commitment. The following article, reprinted from the XIFIN XiConnect Customer Newsletter...

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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...

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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...

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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...

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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...

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Making Telehealth Coverage a Permanent Benefit for U.S. Consumers

One of the most significant legislative changes caused by the COVID-19 pandemic was the temporary measure taken by legislators to cover telehealth visits. It was an overwhelming success in the eyes of patients and providers. Telehealth services rapidly expanded to cover primary care, behavioral health, mental health care, and remote patient monitoring. Now that those rule changes, initiated by...

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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,...

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Pathology Clinical Consultations 2022 Code Additions

The 2022 changes to the CPT codebook include a makeover for the Pathology Clinical Consultation section, eliminating the 80500 and 80502 codes that have been in use since 1997. The CAP CPT Editorial Panel proposed a review of the 80500 and 80502 codes after a study identified these services as potentially misvalued in addition to noting discrepancies in code assignment and utilization. Discussion...

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