Author: PractiSynergy

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PractiSynergy Updates

Unlock a Seamless Healthcare Experience with Virtual Front Desk Solutions

In the constantly evolving world of healthcare, delivering an unparalleled patient experience while efficiently managing administrative tasks is pivotal. The need for real-time insurance verifications and pre-authorization confirmations is more crucial than ever to ensure a smooth flow of operations and patient satisfaction. By embracing [virtual front desk solutions](https://practisynergy.com/virtual-front-desk/), healthcare providers can significantly streamline these crucial processes.

The Significance of Real-Time Insurance Verifications

Insurance verifications are an integral part of the healthcare service delivery process. It’s vital to confirm a patient’s insurance eligibility to avoid any financial mishaps and ensure a smooth patient journey. With a virtual front desk, healthcare providers can automate this process, saving time and reducing errors.

Pre-authorization Confirmations: A Stepping Stone to Enhanced Patient Care

Pre-authorization is another pivotal step that ensures the necessary medical services are covered under the patient’s insurance plan. Acquiring pre-authorization confirmation promptly is crucial to avoid treatment delays and maintain the trust and satisfaction of patients. Through PractiSynergy’s Virtual Front Desk, pre-authorization confirmations can be obtained swiftly and efficiently.

The Future of Healthcare: Virtual Front Desk by PractiSynergy

Embracing the virtual front desk solutions by PractiSynergy not only expedites insurance verifications and pre-authorization confirmations but also transforms the entire administrative workflow into a more streamlined, efficient process. It’s about stepping into the future of healthcare with technology-driven solutions that prioritize both patient care and operational efficiency.

Take the First Step Towards Transforming Your Healthcare Practice

Ready to enhance your healthcare practice’s operational efficiency and patient satisfaction? Discover how the virtual front desk solutions by PractiSynergy can make a significant difference. Explore our services and take the first step towards a streamlined healthcare practice, ensuring real-time insurance verifications and pre-authorization confirmations. Your journey towards superior healthcare service delivery begins here.

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Medical Billing Guide Medical Coding Guide

Demystifying Medical Billing and Coding Part 2

In our last blog, we started the process of demystifying the complicated world of medical billing and coding. We’ve still got a bit more to go to fully provide a comprehensive guide to this field. But don’t worry–if this world seems to be a little too tough to understand on top of everything else going on in your life and in your practice, PractiSynergy is here for you. Instead of struggling to learn the process of medical billing and coding, we’re happy to handle it for you! Let’s dive in. 

The Significance of Coding Systems

There are three major coding systems used in the healthcare industry:

  • The International Classification of Diseases, 10th Edition (ICD-10) is used to classify diagnoses and illnesses.
  • The Current Procedural Terminology (CPT) is used to describe medical, surgical, and diagnostic services.
  • The Healthcare Common Procedure Coding System (HCPCS) is used to code services not covered by CPT, such as durable medical equipment and drugs.

Medical coding relies on standardized coding systems to ensure consistency and clarity in communication. The International Classification of Diseases, 10th Edition (ICD-10) categorizes diagnoses and illnesses, while Current Procedural Terminology (CPT) codes describe medical, surgical, and diagnostic services. Healthcare Common Procedure Coding System (HCPCS) codes cover services not included in CPT, such as medical equipment and drugs.

The Coding Process: Ensuring Accuracy

The coding process involves meticulous attention to detail. Coders collaborate closely with healthcare providers to gather accurate information about procedures and diagnoses. This information is then translated into the appropriate codes, which are submitted for billing. Accuracy in coding is paramount, as it directly influences the reimbursement process and prevents claim denials or underpayments.

Collaboration for Accurate Coding

Effective communication between medical coders and healthcare providers is essential for accurate coding. Coders seek clarifications when needed to ensure that codes accurately reflect the provided healthcare services. This collaboration guarantees that claims are submitted with precision, enhancing the chances of proper reimbursement.

The Medical Billing Process: Submission to Reimbursement

The medical billing process extends from claim submission to reimbursement. Medical billers play a crucial role in this journey by meticulously preparing and submitting claims to insurance companies. This process demands an in-depth understanding of insurance policies, proper documentation, and compliance with regulatory standards.

Challenges and Solutions in Billing and Coding

The realm of medical billing and coding isn’t without its challenges. Claim denials, coding errors, and communication breakdowns can hinder efficient revenue management. However, solutions exist. Thorough documentation, continuous training, and open communication between providers, coders, and billers can mitigate these challenges and optimize the revenue cycle.

Regulatory Compliance: Upholding Industry Standards

Adhering to industry regulations such as the Health Insurance Portability and Accountability Act (HIPAA) and the Stark Law is paramount. Non-compliance can lead to legal repercussions and disruptions in the billing and coding process. Ensuring patient data privacy and adhering to legal standards are critical components of the revenue cycle.

The Impact of Technology

Technological advancements have revolutionized medical billing and coding. Electronic Health Records (EHR) store patient information digitally, enhancing accuracy in documentation and coding. Automated coding tools assist coders in assigning appropriate codes efficiently. However, maintaining a balance between technology and human expertise is crucial to prevent errors and ensure accurate reimbursement.

The Role of AI and Machine Learning

Artificial Intelligence (AI) and Machine Learning (ML) are reshaping the landscape of medical billing and coding. These technologies can analyze vast amounts of clinical data to assist coders in selecting the most accurate codes, reducing errors and enhancing reimbursement optimization. Additionally, predictive analytics offer insights into revenue management and potential risks, enabling proactive measures.

Preparing for the Future: Trends in Medical Billing and Coding

As the healthcare industry evolves, so does the landscape of medical billing and coding. Artificial intelligence, machine learning, and telehealth are emerging as significant influencers. AI and ML technologies promise improved accuracy in coding, while telehealth’s rise necessitates adaptation to coding practices for new service delivery models.

While technology continues to make headway in many different fields, it can never replace the human touch. At PractiSynergy, we know how to utilize these technological advances; but we also know the right questions to ask, the correct steps to take, and of course, to make relationships and connect with other people. 

As telehealth reshapes healthcare delivery, adapting coding practices becomes paramount for precise reimbursement within this evolving service. Amid these dynamic changes, the mastery of these essential processes remains pivotal for sustainable revenue management and top-tier patient care. For comprehensive medical billing and coding services that prioritize seamless payments, consider exploring PractiSynergy—a partner empowering practices to concentrate on quality care while we handle the intricacies of payments…so you don’t have to. 

Contact us today to learn more!

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Medical Billing Guide Medical Coding Guide

Demystifying Medical Billing and Coding Part 1

Medical Billing, Demystifying medical billing, Medical Coding

In the intricate world of healthcare, the seamless functioning of medical billing and coding is essential for both providers and patients alike. This crucial process involves translating complex medical procedures and diagnoses into standardized codes, ensuring accurate revenue management and reimbursement for healthcare services. In this comprehensive guide, we’ll delve into the fundamental aspects of medical billing and coding, its significance, key coding systems, processes, challenges, and future trends–and how PractiSynergy fits into it all. 

What is Medical Billing and Coding & Why is it Important for Providers?

Medical billing and coding are integral parts of the healthcare revenue cycle. Medical billing and coding is the process of translating medical diagnoses and procedures into codes used in medical records and claims submitted to payers for reimbursement. It is a complex and specialized field that requires a deep understanding of medical terminology, anatomy, and disease processes. This symbiotic process ensures healthcare providers receive proper compensation for their services and contributes to efficient revenue management within the healthcare industry. By properly coding and submitting claims, providers can secure timely reimbursement, which is vital for sustaining operations, offering quality care, and investing in advanced medical technologies. This process also helps prevent revenue leakage due to errors or improper documentation.

 It sounds pretty complicated, right? On top of running an effectively functioning practice, managing staff, and of course, treating your patients, correctly getting your billing and coding done can seem like quite the feat. That’s why PractiSynergy exists–so that you can focus on what’s most important, instead of having your hands full with your payments. 

Medical Billing vs. Medical Coding

Medical billing and coding are often used interchangeably, but they represent distinct stages in the revenue cycle. Medical coders are responsible for translating complex medical information into standardized codes, while medical billers focus on submitting these coded claims to insurance companies for reimbursement. Both roles require a keen understanding of medical terminology, anatomy, and coding systems. As a medical provider, learning coding systems on top of the rest of your responsibilities is a taxing undertaking. 

Role of Medical Coders

Medical coders are akin to language translators in the healthcare world. They convert medical procedures, diagnoses, and services into codes from coding systems like ICD-10, CPT, and HCPCS. This translation process ensures that healthcare services are accurately represented, enabling efficient claim submission and accurate reimbursement.

Role of Medical Billers

On the other hand, medical billers are the liaisons between healthcare providers and insurance companies. Their responsibilities include verifying patient information, ensuring proper documentation, navigating insurance policies, and submitting claims. The precision of their work directly impacts the timeliness and accuracy of reimbursement.

Accurate coding and billing not only ensure fair compensation but also contribute to the overall sustainability and success of healthcare practices–it’s absolutely critical to the productivity and profitability of your practice. At PractiSynergy, we know how complicated this field is, and how hard it can be to get it right. That’s what we’re here for! In our next blog, we’ll continue our comprehensive guide so that you can get a better understanding of everything we do. 

Contact us today to learn more.

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PractiSynergy Updates

Lyme Disease: Protect Yourself for the Rest of the Season

As summer comes to a close, it’s essential to remain aware of potential health risks we may have come into contact with, even amidst the joys of the season. One such concern is Lyme disease, a tick-borne illness that has been linked to the summer months. At PractiSynergy, your partner in medical billing, coding, credentialing, and practice management consulting, we believe in not only optimizing healthcare practices but also in promoting awareness and education. 

Understanding Lyme Disease

Lyme disease is caused by the bacterium Borrelia burgdorferi and is primarily transmitted through the bite of infected black-legged ticks, also known as deer ticks. These ticks are most active during the warmer months, making summer a time when the risk of contracting Lyme disease is heightened. While the disease can affect various systems of the body, including the skin, joints, heart, and nervous system, early diagnosis and treatment are key to preventing complications.

The prevalence of Lyme disease during the summer is influenced by several factors, including the increased outdoor activities that come with the warm weather. Hiking, camping, picnicking, and other outdoor adventures place individuals in closer proximity to tick habitats, such as wooded areas, tall grasses, and shrubbery. Ticks are more likely to latch onto exposed skin when people are wearing shorts, t-shirts, and sandals, making skin-to-tick contact more likely.

Furthermore, the summer sun encourages people to spend extended periods outdoors, increasing the likelihood of tick exposure. Ticks thrive in humid environments, and the combination of warm weather and moist conditions creates an ideal breeding ground for these tiny parasites. As a result, individuals who venture into tick-prone areas without proper protective measures are at a higher risk of encountering infected ticks.

Prevention and Awareness

At PractiSynergy, we understand the importance of proactive healthcare management. To minimize the risk of Lyme disease during the summer months, consider the following preventative measures:

Protective Clothing: Wear long-sleeved shirts, pants, and closed-toe shoes to reduce 

the amount of exposed skin. Tucking pants into socks and using insect repellent on 

clothing can also deter ticks.

Tick Checks: After spending time outdoors, perform thorough tick checks on yourself, 

your family members, and even your pets. Pay close attention to hidden areas like the 

scalp, behind the ears, and the groin.

Tick Removal: If you find a tick attached to your skin, use fine-tipped tweezers to grasp 

it as close to the surface as possible. Gently pull upward with steady, even pressure. 

Clean the area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

Landscaping: Keep your lawn well-maintained and free from tall grasses, leaf litter, and 

overgrown shrubs, as these can provide hiding places for ticks.

By staying informed, adopting preventative measures, and seeking medical attention if symptoms arise, you can enjoy the rest of the season while safeguarding your well-being. At PractiSynergy, we’re not only dedicated to your practice but also to promoting the health and wellness of both patients and healthcare providers. Stay connected to our blog for more insightful articles on healthcare topics that matter. Your well-being is our priority.

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Medical Coding Guide

Veterans & Mental Health: What We Can Do

After commemorating our veterans earlier this month with Purple Heart Day, it’s important to remember that vets not only sacrificed their physical well being, but their mental health as well–something that has historically been overlooked and underestimated. The journey to mental well-being for our veterans is a shared responsibility that involves comprehensive support, understanding, and appropriate interventions. Veterans often confront unique mental health challenges stemming from their service experiences. What can we do about it?

Understanding Veterans’ Mental Health Needs:

Service-related experiences can lead to a range of mental health issues among veterans, including but not limited to post-traumatic stress disorder (PTSD), depression, anxiety, and substance abuse. These challenges highlight the need for specialized care and support that acknowledges the complexities of their situations.

Addressing Mental Health Needs Effectively:

The key to supporting veterans’ mental health lies in a multi-faceted approach that goes beyond medical treatments. While professional help is vital, holistic care considers various aspects:

Community Understanding: 

Fostering awareness about veterans’ mental health challenges helps remove stigma, making it easier for veterans to seek help without fear of judgment.

Accessible Resources: Ensuring veterans have access to a variety of resources, from 

counseling services to peer support groups, creates a safety net of support that acknowledges their unique struggles.

Tailored Interventions: Recognizing that each veteran’s experience is different, individualized treatment plans that consider their background, triggers, and preferences can significantly improve outcomes.

Our Role as Medical Professionals:

Medical professionals play a vital role in veterans’ mental health support. We can make a drastic difference in veterans’ quality of life if we address these patients and their unique needs effectively. 

Compassionate Care: A patient, empathetic approach helps create a safe space for veterans to open up about their experiences and challenges.

Accurate Diagnosis: Clinicians trained in veterans’ mental health concerns can provide accurate diagnoses that lay the foundation for appropriate treatment.

Collaborative Efforts: Collaborating with mental health specialists, community organizations, and veterans themselves ensures a comprehensive support system.

Additionally, in PractiSynergy’s role in assisting these medical professionals in keeping their practices productive so that they can continue to treat their patients effectively, we recognize that this can also present challenges in the medical billing and coding side of things. With complex diagnoses and societal stigma, accurately coding and documenting can be daunting. That’s what we’re here for. With successful and accurate coding, veterans can reap more benefits from their mental health care:

 Timely Access to Care: Accurate coding allows veterans to access mental health services promptly, reducing wait times and ensuring that their needs are met in a timely manner.

Comprehensive Treatment: Proper coding ensures that veterans receive comprehensive mental health treatment tailored to their specific conditions. This can include therapy, medication, and other interventions that contribute to their overall well-being.

Reduced Financial Burden: For veterans, mental health care costs can be a significant concern. Accurate coding helps veterans maximize their insurance benefits, reducing out-of-pocket expenses and easing the financial burden associated with seeking help.

Data Analysis and Improvement: Accurate coding generates reliable data that can be analyzed to understand veterans’ mental health trends and needs. This information is invaluable for healthcare providers and policymakers to improve services and allocate resources effectively.

Veterans have served our country, sacrificing their health and safety for the good of the nation and it’s citizens. The least we can do in return is recognize their unique struggles and treat their mental health as a matter of utmost importance, which requires a collective effort from society, medical professionals, and our community. While we are only a small part of that effort, PractiSynergy is proud to do our part by assisting fantastic medical practices with their medical billing and coding so that they can focus on their patients rather than payments. By understanding their unique challenges and providing holistic support that goes beyond medical interventions, we can create a compassionate environment where veterans feel heard, valued, and empowered on their path to mental well-being. 

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Medical Coding Guide

How to Make Wellness Screening Codes Work for You

Did you know that you can earn additional revenue for your healthcare practice by utilizing wellness screening codes? Medicare and various insurance companies provide coverage for preventive services beyond the annual wellness visit in a primary care setting. By taking advantage of specific wellness screening codes, you can bill and get reimbursed for services like alcohol misuse screening, depression screening, and counseling for tobacco cessation. Here’s how PractiSynergy can help your practice identify and maximize billing opportunities.

 

Alcohol Misuse Screening & Counseling:

Alcohol dependence is a prevalent issue that affects many individuals. Medicare and other payers cover an annual screening for alcohol dependence. This screening is defined by certain criteria, including tolerance, withdrawal symptoms, impaired control, and preoccupation with alcohol use. If a patient meets the criteria, your practice can bill for this service once per year. Additionally, for those who screen positive for alcohol dependence, brief face-to-face behavioral counseling can be provided. Behavioral counseling interventions should follow the 5 A’s approach: Assess risk factors, Advise on behavior change, Agree on treatment goals, Assist with behavior change techniques, and Arrange follow-up or other treatment. This counseling service can be billed up to four times per year.

Depression Screening:

Depression is a common mental health condition that often goes undiagnosed. Medicare and other payers offer coverage for annual depression screenings lasting up to 15 minutes. To ensure accurate diagnosis, effective treatment, and follow-up, staff-assisted depression care supports, such as nurses or physician assistants, should be in place. Your practice can bill for this service once per year, allowing you to provide crucial mental health support to your patients while receiving reimbursement.

Counseling to Avert Tobacco Use:

Smoking and tobacco use cessation counseling is an essential service for patients using tobacco, regardless of whether they exhibit signs or symptoms of tobacco-related diseases. Medicare Part B and other payers cover up to eight counseling sessions per year. By offering counseling to help patients quit tobacco, you not only improve their overall health but also increase your practice’s revenue through reimbursable services.

 

Utilizing PractiSynergy:

Identifying and maximizing billing opportunities for wellness screening codes can be a complex process. This is where PractiSynergy can assist your practice. PractiSynergy is a comprehensive healthcare management solution that helps practices optimize their revenue cycle management. With its advanced features and tools, PractiSynergy can identify the services you’re already providing that qualify for reimbursement and ensure proper billing. By leveraging PractiSynergy, you can streamline your billing processes and focus on delivering quality care to your patients while maximizing revenue.

 

Take advantage of the wellness screening codes offered by Medicare and other insurance companies to increase revenue for your healthcare practice. By billing and getting reimbursed for services like alcohol misuse screening, depression screening, and counseling for tobacco cessation, you not only provide essential preventive care but also optimize your practice’s financial performance. With PractiSynergy’s assistance, you can easily identify these billing opportunities and streamline your revenue cycle management. Start leveraging these reimbursement options today and see the positive impact on your practice’s bottom line!

Contact us today!

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Medical Coding Guide

Increasing Payments When Rates Are Decreasing

PractiSynergy understands the challenges faced by healthcare providers in maximizing revenue. With governments tightening their budgets and insurance companies implementing complex reimbursement processes, it is crucial for medical practices to employ strategies that increase cash flow without overwhelming their staff. In this blog post, we will focus on one such strategy: Chronic Care Management (CCM).

 

What is Chronic Care Management (CCM)?

Chronic Care Management, as defined by the Centers for Medicare & Medicaid Services (CMS), refers to the coordination of care services provided outside of regular office visits for patients with two or more chronic conditions expected to last at least 12 months or until the patient’s death. CCM aims to address the needs of patients at significant risk of death, acute exacerbation/decompensation, or functional decline.

 

Reimbursable Opportunities for Providers:

Physicians, along with other healthcare professionals such as physician assistants, clinical nurse specialists, nurse practitioners, and certified nurse midwives, have the opportunity to bill for CCM services. However, it’s important to note that only one practitioner can be paid for CCM services per patient within a given calendar month. We recommend that only the provider responsible for the primary care of the patient bill for CCM services.

 

Understanding the Reimbursement Process:

CCM services are payable for a minimum of 20 minutes spent by clinical staff. Certain healthcare providers may also bill additional codes for extra time spent with patients. At PractiSynergy, we help medical practices determine which patients are eligible for these services and assist in creating a comprehensive plan to ensure all requirements for reimbursement are met.

 

Unlocking Additional Funds with CCM:

By documenting a few extra items in addition to the regular care provided to patients, medical practices can potentially qualify for additional funds through CCM reimbursement. PractiSynergy encourages healthcare providers to reach out and determine if they are eligible to leverage this opportunity.

 

How PractiSynergy Can Help:

At PractiSynergy, we understand the complexities involved in maximizing revenue and navigating the reimbursement landscape. Our team of experts will assist your practice in identifying eligible patients for CCM services and guide you through the process of implementing a reimbursable event. By partnering with us, you can streamline your billing and coding processes, allowing you to focus on providing quality care to your patients while optimizing revenue.

Contact us today!

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The End of the Public Health Emergency: Part 3 – Medicaid DIS-Enrollments

The Consolidated Appropriations Act of 2023, signed by President Biden on December 29, 2022, ends the continuous health coverage requirement for Medicaid members during the public health emergency. While this requirement was in place, Medicaid members did not have to go through the usual annual redetermination of their eligibility for benefits. However, now that this requirement has ended, Medicaid members will receive renewal letters with requests for information. If they do not respond or respond late, they could lose their Medicaid coverage.

States could start this process as early as February 2023, and disenrollment may start on April 1, 2023. This means that some Medicaid members may lose their coverage starting in May 2023. However, many states have opted for an “unwinding” period over the course of twelve months. During this period, Medicaid members who do not respond to renewal letters or requests for information may lose their benefits.

The potential for Medicaid members to lose their coverage could have a significant impact on providers with a high concentration of Medicaid members. Providers may see a negative impact on their cash flow and need to have conversations with patients to encourage compliance with requests for information to avoid disenrollment. Additionally, contingency plans should be in place to ensure payment for future visits. This could include setting a cash-pay or sliding fee policy, providing assistance or information about the plans available on the Marketplace, completing any paperwork required for patients during the redetermination phase, and being available to support an appeal if necessary.

To avoid surprises and non-payment, providers should verify eligibility on all patients. According to the Kaiser Family Foundation, between 5 million and 10 million people will lose their Medicaid coverage as states re-start the redetermination phase. Providers should be prepared for a potential increase in uninsured patients and have plans in place to ensure they are still able to provide quality care to those in need.

The end of the public health emergency marks a new phase in the healthcare landscape. With the end of the continuous health coverage requirement for Medicaid members, providers must be proactive in ensuring their patients have the necessary information to maintain their coverage. This includes having conversations with patients, verifying eligibility, and having contingency plans in place to ensure payment for future visits. By doing so, providers can continue to provide quality care to all patients, regardless of their insurance status.

With our deep expertise in healthcare policy, reimbursement, and regulatory compliance, PractiSynergy has been guiding our clients through the complex and dynamic changes that have arisen with the conclusion of the PHE.  Contact PractiSynergy to learn how to protect your cash flow through these upcoming changes.

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Uncategorized

End of Public Health Emergency – Part 2

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.

Contact us today!

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Medical Billing Guide

End of Public Health Emergency – Part 1 COVID Services

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. 

Contact us today!