billing
publication date
Revenue Cycle
CMS: Pay Attention to Telehealth Billing RulesCMS recommends that organizations review the agency?s most recent guidance on telehealth billing.
Strategy
UVA Health Will Wipe Out Tens of Thousands of Lawsuits Against PatientsThe decision to wipe out liens that can drain home equity years after a hospital visit is extremely rare.
Strategy
Humana Health Plan Overcharged Medicare by Nearly $200M, Federal Audit FindsThe OIG's recommendation to repay, if finalized, would be "by far the largest" audit penalty ever imposed on a Medicare...
Revenue Cycle
Medical Associations Urge CMS to Pause Prior Authorization RequirementsIn their letter to CMS, the AMA, Healthcare Financial Management Association, American College of Surgeons, and other medical groups describe...
Revenue Cycle
Leveraging Coders to Improve HCC AccuracyThis interdisciplinary team will be positioned to identify and address concerns and act quickly to implement education and policy updates.
Revenue Cycle
CPT Coding for E/M Visits With Wound CareThe service must be performed for a condition unrelated to the scheduled visit and must be a new condition that...
Clinical Care
Bundled 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 Cycle
Analysis: CMS Price Transparency Rule Not Working as IntendedMaking "apples-to-apples" price comparisons across hospitals is next to impossible because the data is so muddied and changes so frequently.
Strategy
AHA: CMS Should Overturn Mid-build Denials Issued to PBDsOf the 334 organizations that applied for the mid-build exception, CMS determined that only 132 met the requirements and 202...
Revenue Cycle
OIG: Nevada-based Hospital Overcharged Medicare $23.6M for Rehabilitative ServicesThe OIG found that Sunrise Hospital & Medical Center in Winchester, Nevada complied with Medicare billing requirements for 46 of...
Revenue Cycle
Q&A: Calculating RHC PaymentFor each calendar year, a single deductible is established for Medicare Part B services, including rural health clinic services.
Revenue Cycle
Understanding Clinical Indicators, ICD-10-CM Reporting for CRSElevated levels of cytokines in an overactive immune system can cause harmful levels of inflammation throughout the body and disrupt...