by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment Telehealth has been around for decades, but the COVID-19 pandemic thrust it into the spotlight when patients couldn’t see practitioners in-person. Suddenly, telehealth via video, audio, text, and email became a
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by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment CMS recently announced its Innovation in Behavioral Health Model, intended to “improve quality of care, access, and outcomes for people with mental health conditions and substance use disorders in Medicaid and Medicare.”
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by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment As CMS continues to evolve its Medicare Advantage risk adjustment methodology, significant changes have been made to the behavioral health Hierarchical Condition Categories (HCCs). Starting with the 2024 payment year, the
Read More →– by Jocelyn Bayliss, Program Lead, Provider Network Management & Tina Gallagher, Market Manager, Provider Network Management In April 2023, CMS issued a final rule that added two new specialty types, clinical psychology and clinical social work, to network adequacy standards. Addition of Specialty Types and Amendments
Read More →CMS released the Medicare Program; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, Medicare Parts A, B, C, and D Overpayment Provisions of the Affordable Care Act and Programs of All-Inclusive Care for the
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