Revenue CycleCMS: Pay Attention to Telehealth Billing Rules
CMS recommends that organizations review the agency?s most recent guidance on telehealth billing.
StrategyUVA Health Will Wipe Out Tens of Thousands of Lawsuits Against Patients
The decision to wipe out liens that can drain home equity years after a hospital visit is extremely rare.
StrategyHumana Health Plan Overcharged Medicare by Nearly $200M, Federal Audit Finds
The OIG's recommendation to repay, if finalized, would be "by far the largest" audit penalty ever imposed on a Medicare...
Revenue CycleMedical Associations Urge CMS to Pause Prior Authorization Requirements
In their letter to CMS, the AMA, Healthcare Financial Management Association, American College of Surgeons, and other medical groups describe...
Revenue CycleLeveraging Coders to Improve HCC Accuracy
This interdisciplinary team will be positioned to identify and address concerns and act quickly to implement education and policy updates.
Revenue CycleCPT Coding for E/M Visits With Wound Care
The service must be performed for a condition unrelated to the scheduled visit and must be a new condition that...
Clinical CareBundled Payment Program Reduced Surgery Costs By 50%
The payment model assesses surgical necessity; bundles payments for certain elective surgical procedures; ensures appropriate site of care and use...
Revenue CycleAnalysis: CMS Price Transparency Rule Not Working as Intended
Making "apples-to-apples" price comparisons across hospitals is next to impossible because the data is so muddied and changes so frequently.
StrategyAHA: CMS Should Overturn Mid-build Denials Issued to PBDs
Of the 334 organizations that applied for the mid-build exception, CMS determined that only 132 met the requirements and 202...
Revenue CycleOIG: Nevada-based Hospital Overcharged Medicare $23.6M for Rehabilitative Services
The OIG found that Sunrise Hospital & Medical Center in Winchester, Nevada complied with Medicare billing requirements for 46 of...
Revenue CycleQ&A: Calculating RHC Payment
For each calendar year, a single deductible is established for Medicare Part B services, including rural health clinic services.
Revenue CycleUnderstanding Clinical Indicators, ICD-10-CM Reporting for CRS
Elevated levels of cytokines in an overactive immune system can cause harmful levels of inflammation throughout the body and disrupt...