When it comes to medical billing for surgery, there are various claim submission requirements within Medicare. The largest and most broadly applied is called The Global Surgery Package, or more simply, Global Surgery.
Global surgery refers to all the necessary services performed by a surgeon before, during, and after a surgical procedure. It also includes any necessary services performed by members of that surgeon’s team (provided they practice within the same specialty).
Every year, telemedicine grows in popularity. More than half of U.S. hospitals already have some sort of telemedicine program, and countless more hospitals are currently developing programs. By 2022, analysts believe that the telemedicine industry will be worth as much as $70 billion.
To accommodate this growing healthcare trend, commercial health insurers are increasingly adopting new telemedicine coverage plans, as well as expanding existing plans. For physicians looking to grow their practices, now is the time to jump into Telehealth, as coverage has expanded to the point where it makes fiscal sense. In fact, most mid-range insurance plans now cover telemedicine to some extent.
However, before jumping into this new form of care, it’s important to understand how the reimbursement process works. As with most new forms of medical treatment, The Centers for Medicare and Medicaid Services (CMS) has set the initial coverage standards through Medicare. The commercial carriers have followed suit, with similar coverage rules.
It’s a perfectly reasonable question. Price is a major factor in any business decision. Plus, medical billing company prices aren’t exactly readily available. And when rates are listed, the’re often vague or misleading.
In this article, we’ll attempt to clear up some of the confusion surrounding medical billing service rates. We’ll also give you an idea of what specific services to expect for a given price, along with the factors that go into determining that price.
The Alabama legislature recently passed a bill to restore higher reimbursement rates for certain medicaid providers.
The “bump” in Medicaid reimbursement first came about in 2013, as a requirement of the Affordable Care Act. From 2013-2014, the act required states to pay Medicare level reimbursement rates for certain Medicaid services. When the two-year federal mandate ended, Alabama elected to maintain the higher rates indefinitely.
That is, until July 31st of this year, when the Alabama legislature ended the “bump”, citing budgetary restrictions. Fortunately, this cutback lasted only two months, as the legislature recently voted to reinstate the higher rates, effective October 1st.
Providers looking to take advantage of these rates must meet certain qualifications and take appropriate action in order to participate: