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INSURANCE UPDATES

MD Facts is about Healthcare Updates, Medical Billing Tips & Tricks, Clinical Documentation, EHR, Physician's progress notes, Medical Records and Charting, Medical Coding, Insurance Plans Information, Handling of Insurance Denials, and Insurance Updates.

No Surprises Act (NSA) and TDI Independent Dispute Resolution Mediation
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers. It also establishes an independent dispute resolution process...
Qualifying Payment Amount (QPA), How QPA is Calculated
The qualifying payment amount (QPA) is the basis for determining individual cost sharing for items and services covered by the balance-billing protections in the No Surprises Act (NSA), under certain circumstances. Cost-sharing for emergency items and services and non-emergency items and services furnished by an out-of-network provider in an...
NSA and Balance Billing Laws by State
No Surprises Act (NSA) established new federal protections against surprise medical bills and balance billing, which took effect on 1st Jan, 2022. State-regulated insurance plan (such as employer-sponsored commercial plans): If that state already has a balance billing law deemed by the federal government as meeting certain criteria, the state...
No Surprises Act (NSA), Federal IDR and how it works?
The 2020 No Surprises Act (NSA) established new federal protections against surprise medical bills and balance billing, which took effect on January 1, 2022. For emergency patients visiting a hospital or freestanding emergency room under a state-regulated insurance plan (such as employer-sponsored commercial plans): If that state already has a...
Updated List of Freestanding Emergency Rooms in Texas
  What is a Freestanding Emergency Room? A freestanding emergency department (FSED) is a licensed facility that is structurally separate and distinct from a hospital and provides emergency care. The Texas Freestanding Emergency Medical Care Facility Licensing Act was first enacted in 2009 by the 81st Legislature. An FEMC facility is a...
Toll Free Phone Numbers and Websites of MVA & Auto Insurance Companies in New York
Below is the list of toll-free phone numbers and websites at which patients and billing companies may contact MVA & Auto Insurance Companies. Insurance companies denoted with an asterisk (*) do not offer the ability to obtain a quote or purchase a policy directly through their website. Information on Insurance...
urgent care center visits
By Hannah Nelson April 15, 2021 - While urgent care has deterred lower-acuity emergency department visits over the past decade, a new study published in Health Affairs suggests that the rise of urgent care centers has increased overall costs for low-acuity care. Using claims and enrollment data spanning 2008 through 2019, the...
medicare billing errors
April 06, 2021 - The Office of the Inspector General has identified $23.6 million in overpayments reimbursed to a Nevada-based hospital, resulting from years of Medicare billing errors. In a report released on April 1st, the HHS watchdog reported that the Sunrise Hospital & Medical Center did not fully comply with...
revenue cycle management
How is the flow of revenue in your healthcare practice these days? Or more precisely, how is your revenue cycle management progressing? Medical professionals across the country have been seeing reduced levels of patient traffic during the coronavirus pandemic. Fear of infection keeps some people away from enclosed spaces, including...
CMS Resumes All Hospital Surveys As COVID-19 Cases Lessen
April 07, 2021 - The Centers for Medicare & Medicaid Services has announced the immediate resumption of all hospital survey activities, including those related to Medicare compliance and patient safety. This comes after the agency hit pause on the surveys while hospitals worked to mitigate the COVID-19 crisis. On January 20, CMS issued...