Insurance Reimbursement Articles
Proposed rules revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) services, along with new physician fee schedule (PFS) rule sets will significantly impact providers in 2023.
A number of payment rule changes and unknown future federal and state regulations loom ahead.
Understanding terms used in rule sets pertaining to payment for inpatients, which go into effect during the fiscal year effective Oct. 1, as well as outpatient and physician fee services, which go into effect during the calendar year effective Jan. 1.
Reimbursement for expensive immune globulin (IG) therapies can be challenging and frustrating for providers. Here's a guide to help ensure they are reimbursed for the cost of these medications.
Healthcare costs continue to rise and payment models subsequently evolve, payers nevertheless largely decide which expensive high-investment drugs will be reimbursed and under what circumstances.
