Q: My team is asking me if we should combine pre-admission testing (PAT) visits with the surgery bill. I'm thinking no because some of the PAT services are not routine for the surgery. However, isn't there a rule about services that can't be billed separately prior to surgery?
The Revenue Integrity Symposium is the only conference I have seen that is packed with sessions that will give revenue integrity professionals practical information that they can take back and institute the next day to help their facility success financially.
CMS may have overpaid hospitals, physicians, and freestanding facilities almost $270 million for polysomnography services that did not meet Medicare requirements over a two-year period, according to an Office of Inspector General report.
This week’s Medicare updates include the extension of a final rule on improvements for acute care and critical access hospitals, an OIG report on potential abuse and neglect at skilled nursing facilities, a revision to the July update of HCPCS codes, and more!
Q: Our clinical trial claims often hit edits for missing drugs or devices when those are supplied by the trial sponsor and we can't bill for them. We've been manually reviewing these edits. Is there a recommended method for handling these types of edits that's more efficient?
Commercial and government payers track chronic conditions using Hierarchical Condition Category (HCC), and providers can track HCCs to better monitor and project reimbursement and compliance.
