Each year, CMS reviews procedures on the inpatient-only list, which consists of services typically provided on inpatients and not payable under the OPPS, to consider whether they are being performed safely and consistently in outpatient departments.
Most healthcare systems already have a proven process in place to monitor revenue integrity and ensure correct reimbursement. Beyond the day-to-day revenue cycle staff involved in revenue integrity, more than 60% of hospital executives believe revenue integrity is essential to their organization’s financial stability and sustainability, according to a survey by Craneware, Inc.
This week’s Medicare updates include the release of the End-Stage Renal Disease Prospective Payment System final rule, an announcement of the next round of Medicare Recovery Audit Contractors, the Hospital Outpatient Prospective Payment Changes for 2017 final rule, CY 2017 Home Health Prospective Payment System, a Hospital Appeals Settlement Update, and more!
All coders know that working with physicians is not always a positive experience.
It can be tough providing them education or getting responses from queries. Conversely, providers are busy and typically do not like anything to do with coding. When they hear coding they often take that to mean more work on their part.I have been working with providers for many years and the one thing coders always ask me is, 'What is your secret for getting along so well with doctors and engaging them to change behavior?'
Orders for services are a vital component of ensuring Medicare coverage. With the advent of computerized provider order entry (CPOE), it is important to review order templates in the electronic medical record (EMR) and the resulting order produced or printed in the formal legal medical record to ensure the templates meet requirements.
