Eligibility: Contract Language (Payer v Provider) and Sample to Use
Eligibility: Contract Language (Payer v Provider) and Sample to Use.
Alzheimer Care Coordination Payments
Alzheimer's care coordination payments are financial incentives or compensation provided to healthcare providers or organizations to coordinate the care and support for individuals with Alzheimer's...
Environmental Scan on Care Coordination in the Context of Alternative Payment Models (APMs) and Physician-Focused Payment Models (PFPMs)
This environmental scan was prepared at the request of the Office of the Assistant Secretary for Planning and Evaluation (ASPE) as background information to assist...
Toolkit Managed Care Resource
The Managed Care Legal Database is a resource identifying how state and federal statutes and regulations address many issues that may occur between private payers and physicians, such as prior authorization, credentialing, network adequacy, out-of-network payment, and contract termination. The Database also contains relevant AMA policy, issue briefs, advocacy resources, model legislation, and a State Laws Map.
Changing Demographics & Value Based Care
The United States is going through a fundamental shift in its demographics. By 2035, there will be more seniors than children under the age of 18.
E&M Coding Advice: Simplified
E&M Coding Advice
Physicians and Medicare alike have struggled for many years with correct coding, documentation, and payment of evaluation and management (E&M) services. That’s because, by their nature, E&M services are a diverse set of cognitive procedu
Don’t Lose Revenue With an Outdated Fee Schedule
If you have not updated your practice’s fee schedule for several years, you may be in for some surprises. Carenodes Advisory recommends that you analyze and update your fees annually to make sure they are higher than insurance allowables.