News & Analysis

July 12, 2019
Medicare Web

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 3, 2019
Medicare Web

Anne Arundel Medical Center in Annapolis, Maryland, will pay $3,154,000 to settle allegations that it submitted false claims to Medicare for medically unnecessary evaluation and management services and separately billing bundled procedures

June 12, 2019
Medicare Web

On June 11, CMS published a Request for Information (RFI) as part of its Patients Over Paperwork initiative to collect public input on ways to reduce unnecessary administrative and regulatory burden.

June 1, 2019
Briefings on APCs

If you only bill using the CMS-1500 claim form, then you’ve probably never seen a revenue code. But if you need to bill for facilities, you know revenue codes play an important communicative role between providers and insurers. UB-04 claim forms sent to an insurance company without a revenue code associated with each charge will be rejected.

June 1, 2019
Briefings on APCs

Having taken on more diverse responsibilities, many providers regard medical coding as a necessary evil; their primary focus is caring for their patients. Although many physicians select codes for the work they perform, they rely on specialized coding and auditing professionals to review their documentation and reporting for accuracy.

May 1, 2019
Briefings on APCs

Healthcare organizations and providers are experiencing a shift in outpatient reimbursement: from fee-for-service to Alternative Payment Models and value-based reimbursement based on quality outcomes.

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