CMS introduced the inpatient-only (IPO) list in 2001 to ensure patients who undergo complex, high-risk surgical procedures receive postoperative monitoring services in an inpatient setting.
The IPO list is routinely updated, and it is published annually in the Outpatient Prospective Payment System (OPPS) final rule. Although the list is usually made active in January, healthcare providers can view it a couple of months earlier in November when the OPPS final rule is published. The first IPO list had 300 procedures, but that number has grown to 1,700 in 2023.
Effective leaders are the most valuable asset any company has. Think about the great leaders or managers in your own career. What was it that made them stand out? What was it that made them great? Often, it’s because they took the time to help us develop new skills or they opened doors so that we could grow professionally.
Many in Congress think the government needs to set stricter rules to prevent health insurers’ from slow-walking decisions on whether to approve treatments. But representatives hit a snag last year after their bill to tighten up the “prior authorization” process breezed through the House because senators were concerned about the measure’s projected $16 billion cost.
Audits can be the source of irritation in small and large practices alike.
These necessary evils are often headaches for coders — but they don't have to be. To create a smooth auditing process, consider common misconceptions about the auditing process and discover tips from experts on how to correct them.
Auditing is a process in which select claims are reexamined for accuracy. The types of claims chosen and who conducts the reexamination depend on the parameters of the audit.
Medical coding audits serve many purposes. They provide quality control, improve workflows, and inform future policies and procedures. They also hold coders accountable for productivity, accuracy and communication to help resolve issues, uncover risk and find lost revenue, says Veronica Bradley, CPC, CPMA, senior industry advisor of the Medical Group Management Association in Englewood, Colo.
Below are some corrected misconceptions that coders often have about audits and the auditing process.
A handful of hospital leaders from California discussed how these facilities have attempted to recover from losses in revenues caused by the COVID-19 pandemic at the 2023 Northern California State of Reform Health Conference.
Primary topics of concern included decreased operating margins, workforce shortages, and the increased demand for care.
To ensure more timely patient care, Atlantic Health System has expedited the intricate process of obtaining prior authorizations for diagnostics by reimagining its business processes with intelligent automation at the core.