Welcome to the Revenue Cycle Advisor Website!

June 14, 2018
Medicare Insider

This week's note from the instructor outlines the possible payment pitfalls of a coding clarification CMS included in the July 2018 update to the Outpatient Prospective Payment System. 

June 20, 2018
HIM Briefings

When evaluating a code edit, it’s necessary to understand exactly when or where in the claim or billing process the edit arose. Look to coding guidance to help edit resolution efforts.

June 20, 2018
Medicare Web

How can case managers and social workers assist patients in lowering medication costs?

June 20, 2018
HIM Briefings

CMS plans to rebrand the Meaningful Use program as “Promoting Interoperability.” In a fact sheet, the agency said that the proposed changes outlined in the IPPS rule are meant to improve the use of EHRs and make it easier for providers to spend time with their patients.

June 20, 2018
Medicare Web

The Office of Inspector General (OIG) plans to address concerns regarding capitated payment models by putting preauthorization denials under review.

June 20, 2018
Medicare Insider

This week’s Medicare updates include the release of the 2019 ICD-10-CM code set, numerous updates to the OIG Work Plan, a fact sheet detailing how CMS determines qualifying APM status in the Quality Payment Program, and more! 

June 19, 2018
Medicare Web

In a continued effort to combat the opioid epidemic, CMS released a roadmap detailing its progress toward addressing the crisis as well as its plans for slowing opioid dependence. CMS noted that while the latest Centers for Disease Control and Prevention statistics indicate the opioid epidemic is not slowing down, efforts aimed at combatting the epidemic must continue.

June 18, 2018

CMS issued change request (CR) 10778 on June 15, with an effective date of July 17, to update Chapter 12 of the Medicare Program Integrity ManualThe proposed update includes details for handling non-responders and insufficient responses to additional documentation requests (ADR) under the Comprehensive Error Rate Testing (CERT) program.

June 18, 2018
Briefings on HIPAA

This month's Q&A answers readers' questions about using PHI for healthcare operations, text message encryption, and more.

June 18, 2018
Medicare Web

What are the distinctions between hard and soft coding?

June 15, 2018
Medicare Web

Q: I am confused about the difference between the laterality modifiers -LT (left side) and -RT (right side) and modifier -50 (bilateral procedure). Can you explain?

June 15, 2018
Case Management Monthly

Does your performance under the HRRP truly reflect the quality of care at your organization? There can be vast differences in 30-day hospital readmission rates for patients and conditions studied under the Medicare program, compared to other patients at an organization.

June 15, 2018
Medicare Web

HIPAA requires covered entities to protect and confidentially handle patients’ protected health information. Organizations must remain vigilant or they risk violating HIPAA