An OIG audit of the University of Michigan Health System revealed noncompliance with four types of inpatient claims, including those associated with billing of DRGs, and two types of outpatient claims, including those billed with modifier –59 (distinct procedural service).
CMS announced a new voluntary bundled payment model in January called Bundled Payments for Care Improvement Advanced (BPCI Advanced). Bundled payments, like the ones established by BPCI Advanced, are designed to act as a carrot for healthcare organizations by offering them financial incentives to improve patient outcomes, better coordinate patient care, and rein in spending
CMS recently released guidance on submitting claims and filing appeals as it rolls out its new Medicare cards. The new cards will replace the Health Insurance Claim Number, which is based on the beneficiary’s Social Security Number (SSN), with a Medicare Beneficiary Identifier that is not tied to the beneficiary’s SSN.
This week’s Medicare updates include new skilled nursing facility advance beneficiary notice forms, the 2019 Advanced Notice for Medicare Advantage and Part D plan changes, quarterly HCPCS drug/biological code changes, and more!