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A multidisciplinary approach allows the formation of partnerships between expert professionals that extends beyond the boundaries of their individual specialties, reduces the potential for miscommunication, and eliminates the fragmentation of services that was once common in cancer care.
On July 25, 2018, the Centers for Medicare & Medicaid Services (CMS) released the CY 2019 Outpatient Prospective Payment System (OPPS) proposed rule, and we are seeing several efforts to continue the push towards “site neutral” payments in off-campus provider-based departments (PBDs). This rule was issued weeks after the CY 2019 Physician Fee Schedule (PFS) proposed rule, and the atypical lag time …
Cancer patients are typically treated with approaches ranging from surgery and radiotherapy to chemotherapy or immunotherapy. However, millions of patients every year seek additional options from a menu of complementary and alternative medicine (CAM).
Social workers in cancer centers typically provide psychosocial services to patients, families, and caregivers facing the impact of a cancer diagnosis.
Before enactment of the Affordable Care Act, hospitals began to purchase physician practices and, by converting these locations to outpatient hospital departments, were able to bill for both the professional fee on the CMS1500 claim form and the facility charges on the UB04 claim form.
Since 1992, Medicare has paid for the services of physicians, non-physician practitioners, and certain other suppliers under the Medicare Physician Fee Schedule (MPFS or PFS).
The Susan P. Wheatlake Regional Cancer Center lacked the infrastructure to fund survivorship and navigation software, but still needed to assess how to meet needs, procure service affiliations, and facilitate access to services in a fiscally responsible manner.
The Hospital Outpatient Prospective Payment System (HOPPS or OPPS) is not intended to be a fee schedule, in which separate payment is made for each coded line item. Instead, the OPPS is currently a prospective payment system that packages some items and services, but not others.
The 2018 Medicare final regulations, code updates, and other reimbursement changes will bring significant compensation shifts for oncology providers.
What is the correct number of physicians and support staff needed to meet the requirements of the cancer program? There may not be a single answer to this complex question.
For CY 2015, CMS will continue base payments on geometric mean costs
Ensuring compliance with the myriad of coding and billing regulations is everyone’s job, so make sure you are connected to your Compliance Department, or take the responsibility for compliance into your own hands.
There are procedure codes to report care management services, providing that all documentation requirements are met. It is important to note that while these are billable procedure codes, not all insurers reimburse for these services.
This year we have challenges with physicians and hospitals scrambling to update their respective chargemasters, fee schedules, and other reimbursement documents because in 2015 there are different procedure codes reported based on the radiation oncology setting.
The goal of oral anticoagulation is to maintain levels of anticoagulation capable of preventing thromboembolic events without increasing the risk of hemorrhagic complications.
With the advent of ICD-10-CM, providers on the receiving end of referrals are expecting complete and accurate clinical information that may ultimately be used for diagnosis code assignment to be part of the referral process. But what if the oncologist is the physician referring a patient for a diagnostic imaging study?
If you treat Medicare Advantage patients, you must also know your HCCs (hierarchical condition categories) and your ICDs (International Classification of Diseases).
Since 1992, Medicare has paid for the services of physicians, non-physician practitioners, and certain other providers under the Medicare Physician Fee Schedule (PFS).
Occasions arise when treating a patient where an evaluation and management service and a surgical or infusion service or another procedure occur on the same date.
Currently, nearly 2.3 million U.S. inmates (about 1 percent of U.S. adults) must rely on their jailers for healthcare. However, there is little nationally available data on the health and healthcare of America’s prisoners.
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