Providers grateful for certain opportunities in proposed 2025 Medicare pay rule
By
James M. Berklan
Apr 02, 2024
Even though debate will continue about how much Medicare reimbursement should rise next year, there’s little disagreement that the Centers for Medicare & Medicaid Services got at least a few things right...
CMS proposes appeals process for Medicare patients placed on observation stay
By
Josh Henreckson
Jan 02, 2024
Medicare patients initially admitted to hospitals as inpatients but later reclassified as outpatients under observation would finally have a process to appeal those decisions, thanks to a long-awaited...
An insider’s guide to managed care contract exclusions
By
Susie Mix
Dec 18, 2023
There’s a key question more providers need to know the answer to: What is a contract exclusion? A contract exclusion details the medications and treatments that are not included in the levels of a managed...
Medicare Advantage: A not-so-advantageous deal for beneficiaries and providers
By
Brendan Williams
Nov 29, 2023
Open enrollment is well underway for Medicare, as television viewers inundated with cheesy insurance company ads can tell. Those ads must work. For the first time 2024 will see most Medicare...
In the quest for Medicare patients, Yelp stars outshine Care Compare
By
Jessica R. Towhey
Sep 22, 2023
More consumers are turning to social media review platforms to help choose a nursing home for family members, but the reviews can be skewed by anecdotal and personal evidence, a new study shows.