Revenue Cycle News and Analysis

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Note from the instructor: Understanding and utilizing recent IRF regulatory clarifications

September 23, 2021
Medicare Insider

This week's note from the instructor reviews recent changes to inpatient rehabilitation facility (IRF) regulations and discusses how to use them to proactively create audit defense strategies. 

News & Analysis

Note from the instructor: Understanding and utilizing recent IRF regulatory clarifications

September 23, 2021
Medicare Insider

This week's note from the instructor reviews recent changes to inpatient rehabilitation facility (IRF) regulations and discusses how to use them to proactively create audit defense strategies. 

This week in Medicare updates—9/22/2021

September 22, 2021
Medicare Insider

This week’s Medicare updates include the Quarterly Provider Compliance Newsletter, a proposed rule on repealing the Medicare Coverage of Innovative Technology and Definition of “Reasonable and Necessary” final rule, October updates for various payment systems, and more!

Change management in CDI

September 22, 2021
HIM Briefings

Upgrading and switching EHRs and other technology and applications is a constant cycle at hospitals. Learn how one organization manages change in their CDI program.

Note from the instructor: CMS seeks public input on future rulemaking for REHs

September 17, 2021
Medicare Insider

This week's note from the instructor explores the details of how CMS will establish rural emergency hospitals (REH) and discusses the elements of the Request for Information CMS issued on the topic. 

Unravel competing diagnoses for sepsis

September 15, 2021
HIM Briefings

Identifying sepsis is a complex process that takes more thought than checking off clinical indicators from a list, regardless of what criteria are used to qualify the diagnosis. Apply these tips to identify clinical indicators of competing diagnoses.

This week in Medicare updates—9/15/2021

September 15, 2021
Medicare Insider

This week’s Medicare updates include an extension to the rulemaking process for a final rule on the adjustment of civil monetary penalties for inflation, the recission of the mid-build exception audit determinations, implementation transmittals for two NCDs, and more!

This week in Medicare updates—9/9/2021

September 9, 2021
Medicare Insider

This week’s Medicare updates include information on Hurricane Ida waivers and support, an updated emergency use authorization for bamlanivimab and etesevimab administered together, an OIG review of actions CMS can take to improve COVID-19 data from nursing homes, and more!

Note from the instructor: Charge capture strategies for ensuring compliance and minimizing revenue leakage

September 9, 2021
Medicare Insider

This week's note from the instructor focuses on different methods of charge capture to help ensure compliance and minimize revenue leakage. 

UnitedHealthcare switches from Milliman Care Guidelines to InterQual

September 8, 2021
HIM Briefings

UnitedHealthcare recently transitioned its utilization management approach for all of its health plans from Milliman Care Guidelines to InterQual criteria. Learn how this change could have far-reaching impact on hospitals.

Note from the instructor: CMS reverses elimination of inpatient-only list

September 2, 2021
Medicare Insider

This week's note from the instructor discusses CMS' proposal in the CY 2022 OPPS proposed rule to reverse course on CY 2021 changes to the inpatient-only list and the ambulatory surgical center covered procedures list. 

HIM Briefings, September 2021

September 1, 2021
HIM Briefings

2022 IPPS final rule: CMS opts for alternative data collection, finalizes MS-DRG changes

September 1, 2021
HIM Briefings

CMS walked back some major policy changes and cemented others in the 2022 Inpatient Prospective Payment System (IPPS) final rule. Brush up on the latest changes and ensure your hospital is ready to comply by October 1.