Prime Medical Billing, LLC

10/08/2025

https://www.wafb.com/2025/10/07/landry-announce-medicaid-rate-increase/?fbclid=IwdGRjcANSq7ljbGNrA1KrkGV4dG4DYWVtAjExAAEe7cl76oMMaQORXdhXfL_-9U_JUobjQnu8O84N3zLRt4sZbx-D-7ImkbKgexE_aem_OJp4je5LfZH4J-U9JSfubA

Louisiana health officials announced an increase in Medicaid reimbursement rates for doctors and other providers

10/01/2025

Good Morning, RHC Community –
After a failed Senate vote Tuesday evening, Congress has failed to reach an agreement on funding, resulting in a government shutdown as of midnight.
While certain essential or otherwise shutdown-exempt activities will continue, a significant number of employees at CMS and HHS more broadly will be furloughed during the shutdown. While Medicare and Medicaid payments are not impacted, grants, casework, and some federal technical assistance will be disrupted.
We do not know how long this shutdown will last. Health care policy will continue to be a significant component of these negotiations, as Democrats push for an extension of enhanced premium tax credits that will otherwise expire on December 31 as leverage.
Unfortunately, Congress has also failed to extend Medicare telehealth flexibilities. While not a component of federal appropriations, Congress previously aligned the expiration of these flexibilities with the end of the fiscal year and has not since passed legislation to continue them past September 30.
Beginning today, RHCs will no longer receive reimbursement for providing medical Medicare telehealth services to patients located in their homes. With the expiration of originating and geographic flexibilities, patients will only be eligible to receive telehealth services if they are located in a qualifying medical facility (practitioner’s office, hospital, CAH, RHC, FQHC, SNF, or dialysis facility) that is in a rural area or a health professional shortage area.
While RHCs are still permitted to be distant site (billing) providers of telehealth, per CMS authority until December 31, 2025, this can only be done when the patient themselves is in a facility mentioned above, no longer when the patient is in their home.
This is a disappointing lapse in Medicare telehealth flexibilities for both patients and providers who utilize the benefit, particularly given the bipartisan, popular nature of telehealth. This lapse is expected to last in alignment with the length of the government shutdown.
NARHC understands that this will likely raise many questions, and we continue to be here to support you and advocate for you.
For our weekly (and even more frequent these days!) advocacy updates, ensure that you are tapped into our discussion forum here. This is the primary platform NARHC's DC team utilizes for timely and significant updates.
Please email Sarah.Hohman@narhc.org with any questions!

08/30/2025

This video is how most of us feel that the payers are doing to avoid paying claims:
https://www.instagram.com/reel/DJ-U0eTub4h/?igsh=aDVmZWU2a3Vqcmtl

08/25/2025

https://www.beckershospitalreview.com/finance/why-a-two-tier-medicare-system-may-be-on-the-horizon/

Physicians treating Medicare patients have seen their real income drop by more than 33% since 2016, fueled by stagnant reimbursement, growing Medicare Advantage enrollment and surging operating costs, according to a report published Aug. 18 by Omniscient Health, a data science, research and consulti...

07/15/2025

https://www.cms.gov/newsroom/press-releases/cms-proposes-physician-payment-rule-significantly-cut-spending-waste-enhance-quality-measures-and

CMS Proposes Physician Payment Rule to Significantly Cut Spending Waste, Enhance Quality Measures, and Improve Chronic Disease Management for People with Medicare

06/09/2025

https://www.wipfli.com/insights/articles/hc-tax-how-providers-can-prepare-for-policy-changes?utm_medium=email&utm_term=N%2FA&utm_source=CIJ&utm_content=Tax%20-%20HC%20Election%20Campaign%202%20-%206.4.25%20%28FH%29&utm_campaign=Tax%20-%202024%20Election%20Impact%20on%20Industries

Learn how healthcare providers can prepare for funding cuts, CMS changes and other key policy changes in 2025.

05/17/2025

https://www.wsfa.com/2025/05/16/study-blue-cross-blue-shield-alabama-denial-rate-in-network-claims-highest-country-specific-affordable-care-act-plan/?fbclid=IwZXh0bgNhZW0CMTEAAR7gqQ1iYWBK9d5g6SDJcERO2MwjoJamxbIYoQxMIx6HNogNJ4h0_6-k2zKEEw_aem_h28eKl-7ePsh_rI1sM7aBA

04/30/2025

https://www.aapc.com/blog/92463-ama-releases-cpt-category-i-new-immunization-vaccine-codes/?hss_channel=tw-40981574

Take note of this recent update to keep your coding accurate. The American Medical Association (AMA) has added five Category I codes and revised one Take note of this recent update to keep your vaccine coding accurate.

04/30/2025

https://www.aapc.com/blog/92381-comply-with-cms-documentation-requirement-guidance/?hss_channel=tw-40981574

CMS reiterates documentation requirements, provides improper payment reports, and supports simplification. The Centers for Medicare & Medicaid o help providers understand how to provide accurate and supportive medical record documentation, Medicare Learning Network published an MLN Fact Sheet in Dec...

03/12/2025

Say goodbye to billing headaches. As your medical billing partner, we turn claims into cash - fast and hassle-free.
Focus on patients, not paperwork.
Openings now available. Call or text today, for your free consultation 337-831-9189 or email contact@primemedicalbilling.com

Call now to connect with business.

02/26/2025

https://www.facebook.com/share/v/18gYhSBUX2/

02/26/2025