How we define, diagnose, and document diagnoses that predict morbidity and mortality is essential if we want our patient’s risk to be accurately portrayed.
This week’s Medicare updates include additional information on denial of home health payments when required patient assessment is not received; Advanced Provider Screening phase 1 go-live; an MLN Matters article on billing for Advance Care Planning claims; and more!
This week’s Medicare updates include an OIG report regarding hospital noncompliance with Medicare Requirements for billing outpatient right heart catheterizations with heart biopsies; a new educational initiative to raise awareness of chronic care management; quarterly updates to the ESRD PRICER; and more!
When it comes to using offshore resources, there are several important compliance requirements HIM professionals need to know. These requirements were created by CMS a decade ago and apply to the use of offshore contractors for all Medicaid, Medicare, and TRICARE patients.
This week’s Medicare updates include an OIG Advisory Opinion; new MOON FAQs; a CMS transmittal clarifying admission order and medical review requirements; and more!
In several recent reports, the Office of Inspector General (OIG) determined that providers are, on average, variant from expected volumes on both short stay inpatient and long stay observation cases. What was not made clear in the OIG report is the reason why it believes such variances exist. The answer to this question likely rests within the details of how hospitals have adjusted (or not adjusted) to the use and application of “new criteria” in their daily and ongoing Medicare billing compliance processes.
