News & Analysis

January 27, 2020
Medicare Web

Q: How do we bill for services when our utilization review (UR) team determines postdischarge that an inpatient admission was not medically necessary? Are these services billed as outpatient or inpatient?

January 13, 2020
Medicare Web

Q: What is the process for submitting a claim for an inpatient hospitalization when our utilization review committee determined after discharge that the inpatient admission was not medically necessary?

January 6, 2020
Medicare Web

Q: How do we report total observation time when during the encounter the patient also received bundled services that include observation?

December 4, 2019
Medicare Web

Carolinas Hospital in Florence, South Carolina, received $431,757 in Medicare overpayments for incorrectly billed inpatient and outpatient services, according to an Office of Inspector General (OIG) audit report released November 26. Based on the sample, the OIG estimates the hospital may have received at least $3.4 million in overpayments.

November 25, 2019
Medicare Web

Q: What is Medicare's criteria for case-by-case approval of an inpatient stay when the patient is not expected to meet the 2-midnight benchmark?

August 9, 2019
Medicare Web

While there are many conferences that touch upon aspects of revenue integrity, RIS is the only one entirely dedicated to the topic. Plus, it is a great way to meet other professionals in the field of revenue integrity who are facing similar challenges and have similar interests.