Year: 2023

End of Public Health Emergency – Part 2

Post author By PractiSynergy
Post date March 16, 2023
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As the end of the public health emergency (PHE) approaches, it’s important for medical billing and coding businesses like PractiSynergy to stay up-to-date on the latest developments in telehealth services. During the PHE, the US Department of Health and Human Services made significant changes to the requirements for patients to access and for medical professionals to provide telehealth services.

Thanks to the Centers for Medicare and Medicaid Services (CMS) enacting waivers, providers were given greater flexibility in using telehealth services for their patients. But what happens when the PHE ends? In December 2022, President Biden signed the Consolidated Appropriations Act which extended the telehealth waivers through December 31, 2024. This means that the following temporary benefits will still be in effect:

No geographic restrictions on telehealth originating sites, including in a patient’s home
Telehealth visits may be delivered using audio/video or audio-only platforms
In-patient visits will not be required within a certain timeframe of a telehealth visit for mental/behavioral health
Physical and Occupational Therapists, Speech Language Pathologists, and audiologists may offer telehealth services
Services may be rendered outside of a provider’s state of enrollment
Federally Qualified Health Center (FQHC)/Rural Health Clinic (RHC) can serve as a distant site provider for non-behavioral/mental telehealth services.

However, it’s important to note that one element of the PHE telehealth service will end with the end of the PHE. Providers will now be required to use HIPAA-secure means of communication platforms while providing services. This means CMS will no longer allow chat applications such as FaceTime, Google Hangouts, WhatsApp video chat, etc. as a method to communicate with patients.

It’s essential to stay current on these changes to telehealth services. By doing so, providers can continue to offer high-quality care to their patients in a way that’s safe, secure, and compliant with all applicable regulations. At PractiSynergy, we’re committed to helping our clients navigate these changes and stay ahead of the curve when it comes to telehealth services.

Tags Covid, Medicaid, practisynergy, practisynergy blog, Public Heath Emergency

Medical Billing Guide

End of Public Health Emergency – Part 1 COVID Services

Post author By PractiSynergy
Post date February 15, 2023
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It’s the end of the Public Health Emergency (PHE) as we know it! Under the PHE, private and government health insurers could not apply any cost-share amounts (co-pays, co-insurance, deductibles, etc) for COVID testing, COVID vaccines, certain treatments, or anti-viral drugs such as Paxlovid. Starting May 11, 2023, however, some of these COVID-related services will be changing.

So what do you need to be aware of?

At the end of the PHE, Medicare Beneficiaries Cost Share will be reinstated. Meaning, COVID testing (at home and otherwise, except when being treated by a doctor to rule out COVID) and COVID treatments except for oral anti-viral drugs such as Paxlovid will now be able to be applied with cost-share amounts.

For Medicaid and CHIP, no cost share will be applied to COVID vaccines or the administration of COVID vaccines for adults and children. Additionally, until the last day of the first calendar quarter one year after the end of PHE (September 30, 2024), no cost-share amounts can be applied.

Finally, Private Health Insurance may reinstate patient cost share and may require prior authorization to cover COVID testing and testing-related services, as well as patient cost share for vaccines and vaccine administration. Private Health Insurance will also no longer be required to reimburse out-of-network providers for COVID tests, testing-related services, vaccines, or vaccine administration.

As we celebrate coming to the end of this Public Health Emergency brought on by the COVID-19 pandemic, we also need to remain aware of the changes that will come with it. But with PractiSynergy, you don’t need to spend your time being vigilant over these changes or focusing on getting every detail right. We handle all things medical-billing and coding so that you can spend your time on what matters most, your practice and your patients.

Tags Covid, Medicaid, practisynergy, practisynergy blog, Public Heath Emergency

Medical Billing Guide

Should You Outsource Your Small Practice’s Billing?

Post author By PractiSynergy
Post date January 17, 2023
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We know that you and your practice have a lot on your plate. There’s lots to get done, and you can’t do everything! The revenue cycle is a time-consuming, complicated process, so should you outsource your billing?

While it’s understandably tempting to want to have your part in all aspects of your practice, you’ll have to ask yourself if it’s worth sacrificing time and energy for the billing process. Will internally learning, understanding, and doing all functions of the revenue cycle contribute to a better understanding of the practice’s financial position? Here’s why you should consider letting an external company like Practisynergy take the weight of billing off of your shoulders.

The revenue cycle is dense and complicated, and running your practice is a big task already. It would be nearly impossible for one person to be an expert on each part of the revenue cycle; verifying insurance eligibility and benefits, medical billing and coding, managing claims, denials, and accounts receivable, answering questions about medical bills, and more; taking care of each of these would be extremely difficult, especially on top of other duties.

The cycle is also time-consuming, taking valuable time and energy from your patients. You would need to find the time to appeal claim denials, make sure your billing and patient statements are accurate, manage insurance credentialing and contracts, et cetera. With all that time dedicated, you may also need to bring on more employees to pick up the slack, especially in case of vacation or illness to keep claims going out the door.

This is a heavy burden for any one person to bear. As you’re running your practice, don’t add this weight to your load. While you stay focused on your patients, let PractiSynergy take care of your medical billing and coding. With our smooth process to transition a practice from in-house billing to us, and a model that fits your needs and increases revenue, you won’t regret switching to PractiSynergy.

Tags billing, billing companys, companys, outsouce, practisynergy, practisynergy blog, when to outsource