Facilities can limit their exposure to claim denials and external reviews by implementing a robust internal coding compliance program. This article breaks down components of a coding policy and compliance plan and approaches to monitoring coding quality.
Certain provider services such as acupuncture and cosmetic surgery are not reimbursed by Medicare. This article describes when and how to apply HCPCS modifiers for non-covered services.
Although there are basic expectations of a utilization review (UR) team member, organizations should develop performance expectations and competencies for their UR staff based on their own needs. Use this sample UR specialist job description as a template for your organization.
This week’s Medicare updates include the April update for the OPPS, the April update for the Ambulatory Surgical Center Payment System, a revision to the Program Integrity Manual to clarify information regarding provider enrollment, and more!
This week’s Medicare updates include new additions to the OIG Work Plan, an advisory opinion on subsidizing items in a clinical trial, an OIG data brief on telehealth use, and more!
