New Medicare Policies that Temporarily Boost Medicare and Medicaid Reimbursement
The CARES Act attempts to alleviate some of the financial strain on hospitals, physicians, and other health care providers through a series of new Medicare policies that temporarily boost Medicare and Medicaid reimbursement and allow for added flexibility.
Policy updates include:
During the period beginning on May 1, 2020 and ending on December 31, 2020, the Medicare programs under title XVIII of
the Social Security Act (42 U.S.C. 1395 et seq.) shall be exempt from reduction under any sequestration order issued before,
on, or after the date of enactment of this Act.
The annual 2% cut, or “sequester,” in Medicare payments to hospitals, physicians, and other providers is cancelled for the
rest of calendar year 2020. In order to offset the added expense of the 2020 cancellation, the CARES Act extends the sequester
by one year, through 2030. (Section 3709)
This post was first published April 1, 2020 and was updated July 29, 2020.
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"National Medical’s coding audit identified that our previous billing partner was coding and billing our ASC claims improperly. We were actually losing money on some cases because costly implant charges were not being coded and billed correctly. National Medical was able to go back and capture significant lost revenue. Their specialized, ASC expert coders have maximized our revenue and compliance."
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ASC ADMINISTRATOR | FREMONT, CA
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"National Medical’s expertise in the ASC market revealed that our contracts were reimbursing less than Medicare and in some cases only 38% of Medicare. Due to their expertise and experience, they were able to renegotiate better contracts and increase our contract reimbursement by 305%. We’re now able to bring additional cases to our center."
ASC ADMINISTRATOR | BALTIMORE, MARYLAND
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"Before we hired National Medical, we were handing billing in house and were averaging $811 for each surgery. In our very first year with National Medical, with the same number of cases, we have increased our cash per case to $1,400. That represents an increase of approximately $600 per case, or 73 percent, all of which is pure profit for us. In absolute terms, that means an additional $90,000 per month to us on the same number of cases."
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“We have not second guessed our decision to switch billing companies once since transitioning to National Medical. Their team seems to remind us constantly why it was such a good decision!
ASC ADMINISTRATOR | SOUTHLAKE, TX
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"National Medical consistently exceeds our expectations by going above and beyond every day. Their team is proactive, highly attentive and smart. To top it off, their detailed analytics team provides us with powerful insights into our business, allowing us to make informed decisions. In short, they are the perfect partner for all of our revenue cycle needs."
CHIEF OPERATING OFFICER, SURGERY CENTER | PORTLAND, OREGON