Posts Tagged Insurance

GAO: Most Air Ambulance Providers Out-of-Network for Privately Insured

More than two-thirds of air ambulance transports for patients with private insurance were out-of-network in 2017, putting patients at financial risk for the difference charged, according to a recent report by the Government Accountability Office (GAO). GAO analyzed a private health insurance data set for

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Study: For-profit Insurers More Likely to Exercise Market Power

For-profit insurers are more likely than not-for-profit insurers to exercise market power when they have it, according to a new study by Harvard Business School professor Leemore Dafney. The author looked at Blue Cross and Blue Shield affiliates that converted to for-profit status in 11

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NCHA Comments on CMS Proposed Rule on Medicaid and CHIP Managed Care

NCHA submitted a comment letter on the Centers for Medicare & Medicaid Services’ (CMS) Medicaid and Children’s Health Insurance Plan (CHIP) Managed Care proposed rule. NCHA is pleased with CMS’s recognition of the critical nature of the use of pass-through payments as a mechanism

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CMS: 2019 HealthCare.gov Enrollment Tops 4.1 Million

More than 4.1 million people, 236,693 in North Carolina, selected a 2019 health plan through HealthCare.gov between Nov. 1 and Dec. 8, including more than 934,000 last week, the Centers for Medicare & Medicaid Services reported this past week. Almost three-quarters of those selecting plans were

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Report: Workers Spending More for Health Insurance

Employees contributed an average of $1,415 toward premiums for single coverage and $5,218 for family coverage in 2017, according to a report released recently by the Commonwealth Fund. The employee premium contributions were 6.8 percent higher for single health coverage and 5.3 percent higher for

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Webinar: Coding, Billing & Reimbursement for Non-Emergent Care in the Emergency Department (ED)

This webinar addresses the levels and types of services in the ED and differentiates between emergent, urgent and clinical levels of services. The program will help personnel understand the reasons for increasing volumes of urgent and clinical level services in the ED, theRead more

Webinar: EMTALA Update 2018: Part 3 of 3 – The Most Cited Deficiencies by CMS for Hospitals

Every hospital that has an emergency department and accepts Medicare or Medicaid reimbursement must follow the federal law and Centers for Medicare & Medicaid Services (CMS) interpretive guidelines on Emergency Medical Treatment and Labor Act (EMTALA). This includes critical access hospitals. During PARTRead more

Webinar: EMTALA Update 2018: Part 2 of 3 – The Most Cited Deficiencies by CMS for Hospitals

Every hospital that has an emergency department and accepts Medicare or Medicaid reimbursement must follow the federal law and Centers for Medicare & Medicaid Services (CMS) interpretive guidelines on Emergency Medical Treatment and Labor Act (EMTALA). This includes critical access hospitals. During PARTRead more

Webinar: EMTALA Update 2018 – Part 1 of 3 – The Most Cited Deficiencies by CMS for Hospitals

Every hospital that has an emergency department and accepts Medicare or Medicaid reimbursement must follow the federal law and Centers for Medicare & Medicaid Services (CMS) interpretive guidelines on Emergency Medical Treatment and Labor Act (EMTALA). This includes critical access hospitals. PART IRead more

Webinar: Physician Supervision & Incident-To Compliance

The phrase “Incident-to” is used in two very different ways in the Social Security Act (SSA).  For physicians and practitioners this phase is used for incident-to billing that relates to a physician coding and billing for subordinate staff services. For hospitals, the phaseRead more

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