News & Analysis

July 12, 2019
News & Insights

The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is key to revenue integrity success. Understanding its benefits and limits is important for any successful revenue integrity program.

July 12, 2019
News & Insights

The Nemadji Research Corp., a patient eligibility and billing service based in Minnesota, announced that the protected health information of thousands of patients may have been exposed earlier this year after a Nemadji employee fell victim to a phishing attack.

July 12, 2019
News & Insights

Q: What is the appropriate ICD-10-CM code assignment for acute cellulitis in a patient with Type 2 diabetes?

July 11, 2019
Medicare Insider

This week's note from the instructor addresses some of the issues arising from the start of a new Quality Improvement Organization (QIO) contracting cycle. 

July 10, 2019
Medicare Insider

This week’s Medicare updates include a decision memo for an ambulatory blood pressure monitoring NCD, another extension of enforcement discretion for the laboratory date of service exception policy, a fact sheet on proper billing processes for DMEPOS items delivered to inpatients, and more!

July 10, 2019
News & Insights

Accountable care organizations (ACO) avoid downside risk contracts even though the number of ACO contracts and ACOs with multiple contracts have grown, according to a recent study. The study authors suggest that stronger incentives to take on downside risk are necessary to ensure the success of the ACO model.

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