What Does a 3% Implant Revenue Leak Cost a Texas Surgery Center?

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  Implant costs represent one of the largest expenses for many Texas Ambulatory Surgery Centers (ASCs) . Orthopedic, spine, pain management, cardiovascular, and other specialty procedures often involve high-cost implants that require precise documentation, charge capture, coding, and reimbursement. Even a seemingly small 3% implant revenue leak can result in tens or hundreds of thousands of dollars in lost revenue each year. Many surgery centers assume declining profitability is caused by rising supply costs or lower reimbursement rates. In reality, hidden revenue leakage often begins with missed implant charges, inaccurate coding, incomplete documentation, payer-specific billing errors, or delayed claim submission. This is why more ASCs are investing in specialized ASC Billing Services , comprehensive medical billing services , advanced RCM services , and proactive Revenue Integrity programs to protect implant reimbursement and improve financial performance. What Is an Implant R...
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Skilled Nursing Facility 3- Day Rule Waiver

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CMS is waiving the requirement at Section 1812(f) of the Social Security Act for a 3-day prior hospitalization for coverage of a skilled nursing facility (SNF 3- Day Rule Waiver) stay provides temporary emergency coverage of SNF services without a qualifying hospital stay, for those people who need to be transferred as a result of the effect of a disaster or emergency. In addition, for certain beneficiaries who recently exhausted their SNF benefits, it authorizes renewed SNF coverage without first having to start a new benefit period. Second, CMS is waiving 42 CFR 483.20 to provide relief to SNFs on the timeframe requirements for Minimum Data Set assessments and transmission.

Background

Under the Shared Savings Program, the Centers for Medicare & Medicaid Services (CMS) enters into a participation agreement with each participating Accountable Care Organization (ACO). CMS will reward eligible ACOs when they lower growth in Medicare Parts A and B fee-for-service (FFS) costs (relative to their ACO-specific benchmark) if, at the same time, they meet performance standards on quality of care.

The SNF 3-Day Rule Waiver waives the requirement for a 3-day inpatient hospital stay prior to a Medicare-covered, post-hospital, extended-care service for eligible beneficiaries. Only Shared Savings Program ACOs that are currently participating in, or applying to, certain Shared Savings Program performance-based risk tracks have the opportunity to apply for a waiver of the SNF 3-Day Rule, and they must apply separately for the waiver during the annual application process.

Read more regarding Skilled Nursing Facility 3- Day Rule Waiver: https://bit.ly/3e5qNev. also you can get in touch with us at info@medicalbillersandcoders.com or call us at 888-357-3226.

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