Part B News | Part B News

Glimpsing the future: Legal challenges, COVID rules (again), new codes and more

01/02/2023

Welcome to our annual predictions issue, where Part B News attempts to peer through the chaos and pick out the pivotal events that will define the new year for medical practices. After scouring the minds of a host of industry insiders and asking our readers for their take on looming events, Part B News compiled 10 predictions touching on coming changes, updates, upheavals and trends.

PBN’s 2022 predictions: PHE, NSA? Yes. Vaccines, telehealth? Not quite.

01/02/2023

by: Part B News Staff

In our annual predictions issue, Part B News looks back on how well we fared calling shots during the previous calendar year. Heading into 2022, we staked a claim on the duration of the COVID-19 public health emergency, the fate of split/shared services, revenue projections and more. Here is an unabashed look at our 2022 results.

Online exclusive: 3 more PBN predictions for 2023

01/02/2023

by: Part B News Staff

Anticipate how to grapple with social determinants of health (SDOH), Medicare's split/shared billing policy and more.

Practices to dial up denials, collections strategies to offset pay cuts

01/02/2023

by: Richard Scott

Practices are on the verge of stepping up their denials management strategies in 2023 as Medicare Part B rate cuts are expected to impact revenue. On the delivery side, most practices plan to continue their telehealth operations in the new year.

Patient insured, but can’t afford care? Seek terms with payer for a cost break

12/19/2022

by: Roy Edroso

With high-deductible plans on the rise, it’s increasingly likely that you’ll see patients who, though insured, can’t afford their coinsurance payments. You can offer help, but take care not to run afoul of your payers.

Billing incident-to? Block 3 threats to the direct supervision requirement

12/19/2022

by: Julia Kyles, CPC

When physicians push for new and creative definitions of incident-to billing, it is up to coding and compliance staff to explain the rules. Watch out for mistake-prone areas to avert billing errors.

New prior auth rule aims for API adoption, 7-day turn by 2026

12/19/2022

by: Roy Edroso

Prior authorization, longtime bane of providers, is on track to get less burdensome thanks to a new proposed rule. The good news is it includes Medicare Advantage, left out of a previous version. But results, already delayed once, may still come slowly.

Incorporate updates, addendums to medical records while maintaining compliance

12/19/2022

by: Holly Cassano, CPC, CRC

Since the adoption of electronic health records (EHR) became commonplace in hospitals and medical practices nearly two decades ago, more people have access to the records than before. Now more than ever, the practice of keeping accurate records has shifted to accommodate the move from paper to screen.

CMS’ prior authorization reform would reap $15B over 10 years

12/19/2022

by: Richard Scott

A CMS plan to streamline the prior authorization process for certain payers would slash the amount of time spent chasing approvals and save providers billions.

To beat ACP problems, study up and get NPP, post-acute help

12/12/2022

by: Roy Edroso

The pandemic has been a bumpy time for Medicare’s advance care planning (ACP) service, with a slowed adoption rate and, per a new OIG report, providers making basic mistakes in their claims. But legislators and experts are pushing hard to make the service easier and more available.

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