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What’s the Latest From CMS? Find out in Episode Three of Our Webinar

By | Blog, COVID-19, Webinar

If you’ve been following the latest updates coming from CMS, you’ve likely noticed changes are being announced daily. Our weekly COVID-19 Insights webinars help by keeping up with all the updates and focusing on how they may affect your business.

Episode three of the webinar will be available this Thursday, April 9th at 2 PM Eastern time. Besides going over the latest regulatory updates from CMS, this week we’re covering SBA loans and Fee-for-service Advance/Accelerated Medicare payments.

Every COVID-19 webinar can be watched on our official YouTube page: http://www.youtube.com/careoptimize. You can also visit the Insights page on our website to stay on top of the latest CareOptimize updates: https://careoptimize.com/insights/.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.

Check out Episode Two of the CareOptimize Insights Webinar

By | Blog, COVID-19, Webinar

The CareOptimize COVID-19 Webinar continues this week. Some of the topics you can look forward to in Insights Webinar COVID 19 Episode 2 include CMS Waiver updates, Medicare Advanced Payment, and changes with telehealth and telemedicine.

This webinar also highlights three distinct provider models and how they have adjusted to the changes and challenges in the healthcare industry brought on by the COVID-19 pandemic. Featured, too, are the CareOptimize COVID-19 Template and Report utilities, technology developed to streamline COVID-19 reporting and monitoring.

Next week’s webinar will be on Thursday, April 9th at 2PM EST. Topics will be announced soon. Remember you can watch all of the webinars by visiting our YouTube page: www.youtube.com/careoptimize, or our website www.careoptimize.com/insights.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, nextgen EHR utilities, and more. For more information, please call 855.937.8475.

Coronavirus Webinar Series Ep. 2

By | Blog, COVID-19, Webinar


Last week began our weekly CareOptimize COVID-19 Webinar Series. The first of these webinars focused on CMS regulatory program submission changes and recent updates and how telemedicine and telehealth are quickly becoming new sources of revenue.

In this week’s CareOptimize COVID-19 Webinar, we will continue bringing you the most up-to-date news from CMS along with other regulatory changes affecting the healthcare industry. Our primary focus is on a trio of distinct provider models and how each of them is managing their practices while adapting to the challenges of the pandemic. We’ll also be going over the technology CareOptimize has developed aimed at streamlining COVID-19 monitoring and reporting.

This week’s CareOptimize COVID-19 Webinar will be held this Wednesday, April 1st at 2 PM Eastern Time. To register for this webinar, please click the following link. You can watch all of the previous webinars by visiting the official CareOptimize page on YouTube or visiting the Insights page on our website.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.

Watch the First of Our COVID-19 Webinar Series

By | Blog, COVID-19, Webinar

As the COVID-19 pandemic continues to affect practices, we’re doing what we can to help practices adapt to the challenges. In case you missed it, we recently kicked off the first of our CareOptimize COVID-19 Webinar Series.

The first edition was held this past Wednesday and focused on the recent trends and innovations in the healthcare industry such as regulatory billing and optimum practices to improve revenue. We also took a close look at CMS regulatory program submission changes and several of the differences between Telemedicine and Telehealth.

You can register to our next Webinar by clicking the link. Make sure to bookmark our YouTube page and be sure to subscribe to stay updated on future webinars.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.

Join Us for the COVID-19 Initiatives Webinar

By | COVID-19, Webinar

As the COVID-19 pandemic continues to spread, some practices may be overwhelmed while others may be forced to close. In response to the pandemic, CareOptimize will be hosting weekly online webinars talking about what practices should be doing during these difficult times.

Each CareOptimize webinar will be centered around the latest updates and developments in the healthcare industry, including regulatory billing and best practices to maximize revenue during this challenging period. The first of these weekly webinars will be held this Thursday, March 26 at 2 PM Eastern time. Other topics will include:

  • The latest updates on CMS regulatory program submission changes
  • Telemedicine versus Telehealth, including documentation and system requirements
  • Chronic Care Management (CCM) requirements, revenue, and how specialists can take the initiative and get involvedWe will also showcase real-world examples of distinct provider models and how each is handling the challenges faced by their practices during the pandemic.

To join or view this week’s COVID-19 The CareOptimize Response webinar, please visit or bookmark the following link

Streamline Your Revenue Cycle Management With a Basic Approach

By | Blog

Per a recent HFMA survey, nearly 70% of leaders in healthcare revenue cycle are putting funds toward technology capable of improving the integrity of revenue, getting rid of human error, and boosting efficiency. Yet a major and largely unexplored opportunity for many companies to boost performance comes down to a familiar word: data.

Healthcare organizations still have a long way to go in areas like addressing out-of-pocket cost concerns with consumers, reducing collection costs, and cutting down on the rise of initial denial rates. A back to basics approach could be a viable solution even as digital automation becomes prevalent.

By performing some analysis, revenue cycle leaders can take a look at potential breakdowns during the revenue cycle process before they become a major issue. For example, an organization dealing with an unusually high discharged-not-final-billed (DNFB) rate can do analysis to figure which types of claims are stalling the claims submission process.

Data analysis provides revenue cycle leaders with a roadmap of where traditional claim processing failures originate and the forms of claim rejections and denials most commonly encountered. These may include additional documentation, failing to acquire prior authorization, or not filing on time.

To read more about the HFMA survey, visit https://guidehouse.com/insights/healthcare/2019/hfma-rcm-survey.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.

Medicare Reimbursement Information for COVID-19 Tests Has Been Released

By | Blog

Following closely on the recent billing codes released by the Centers for Medicare & Medicaid Services (CMS), the federal agency is now allowing clinical laboratories to know what Medicare reimbursement they will receive for performing COVID-19 tests on patients. The amounts are typically $36 and $51 for CDC and non-CDC test kits, respectively. However, these numbers could vary.

CMS released new Healthcare Common Procedure Coding System (HCPCS) codes on March 5 and February 13 for healthcare providers and labs to check patients for COVID-19. HCPCS code (U0001) is intended to acquire diagnostic research carried out by accredited laboratories using CDC tests. The other code (U0002) will be used to bill COVID-19 for all non-CDC laboratory tests, including those produced in-house under the most recent FDA guidelines.

The World Health Organization has officially deemed COVID-19 a pandemic and it is putting tremendous strain on the healthcare system, particularly here in the United States. Industry leaders have expressed fears that resources are not adequate to handle a large influx of people that may be infected with the virus.

Diagnostic testing will likely play a critical role in monitoring virus spread and maintaining hospital capacity as the number of COVID-19 cases grow. To read more, https://revcycleintelligence.com/news/cms-releases-medicare-reimbursement-details-for-covid-19-tests.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.

COVID-19 and Its Effect on the Healthcare Revenue Cycle

By | Blog

As nations are ramping up their efforts to deal with COVID-19, healthcare providers are being proactive in their response to the coronavirus outbreak. These efforts may have a considerable effect on the revenue cycle for health care and the budgets of the providers.

Coronavirus has been a major concern for health care providers on the frontline of tracking and treating infected people. The impact COVID-19 will have on the health-care revenue cycle and financial operations is among their concerns.

Maintaining the billing office in optimum operation during an epidemic is key to keeping hospitals and clinics open to people who are sick and need treatment. But this can be a challenge to respond to COVID-19 demands, particularly for smaller organizations with a limited amount of funds available.

The COVID-19 outbreak also illustrates issues relating to the financial responsibility of patients. Accounts have surfaced of patients left with medical bills of thousands of dollars after seeking care for suspected symptoms of coronavirus. Healthcare providers in the age of high deductible health plans and other cost-sharing programs are struggling to build collection strategies.

Payers recognize the efforts arising from financial responsibility for patients and many are taking steps to ease the process for patients to seek care and for providers to simplify the financial encounter.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.

Coronavirus Billing Codes Have Arrived

By | Blog

With the country on edge because of COVID-19 (better known to the masses as the coronavirus), the Centers for Medicare & Medicaid Services (CMS) have revealed new billing codes for testing the virus in labs. With these new billing codes, providers and clinical laboratories can be reimbursed for assisting patients with the virus while keeping a close eye on new cases and conducting tests. The codes have already been adopted by the Healthcare Common Procedure Coding System (HCPCS) which is utilized by insurers as well as Medicare for claims processing.

U0001 is the first billing code, released last month and aimed squarely at SARS-CoV-2 diagnostic tests done at CDC research laboratories. The second billing code (U0002) published earlier this week will allow laboratories to bill for non-CDC laboratory tests for SARS-CoV-2/2019-nCoV, or simply, COVID-19.

Per the most recent World Health Organization figures, there are more than 95,000 cases of coronavirus around the world. Of those cases, close to 100 of them are in the United States.

In light of the coronavirus, CMS has also given a call for action to health care providers. The agency recently urged providers to make sure that they are enforcing proper infection control protocols.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, MIPS consulting, and more. For more information, please call 855.937.8475.

CMS Moves Forward With ET3

By | Blog

The Centers for Medicare & Medicaid Services (CMS) recently found the applicants that will become part of its Emergency Triage, Treat, and Transport (ET3) Model initiative. The five-year payment model will provide increased flexibility for ambulance response services following a 911 call to meet the emergency healthcare of necessities of Medicare Fee-for-Service beneficiaries. The participating applicants are comprised of ambulance providers and service suppliers in more than thirty states, all of which are Medicare-enrolled.

CMS revealed last February the ET3 model is aimed at establishing a new range of opportunities for emergency transportation and care, ensuring that patients receive convenient, effective treatment in the environment they feel is appropriate for them.

The goal was to promote more efficient use of facilities, ensuring that patients are handled expeditiously and fairly by Medicare-enrolled providers and suppliers. The model could result in Medicare savings of more than $500 million a year by sending patients to doctor’s offices versus the emergency room.

Currently, Medicare will only provide payment for emergency ground ambulance services should a patient be taken to certain facilities, usually a hospital emergency room. With ET3, Medicare will pay participating ambulance providers to transport a patient to an alternate destination, such as an urgent care clinic, for example.

This update is provided by CareOptimize. We provide healthcare management consulting services and products and we’ve helped numerous healthcare organizations succeed for more than a decade. We provide managed care solutions as well as products like coding modules, next-generation EHR utilities, and more. For more information, please call 855.937.8475.