Q: Our utilization review (UR) committee originally took a more strictly peer review role but over time its scope and responsibilities have broadened. We're not sure that it still makes sense for the UR committee to be categorized as a subcommittee of the medical staff. What is the current recommended reporting structure for a UR committee?
CMS recently announced a new category of payment programs: the Primary Cares Initiative. Within a few years, CMS expects 25% of primary care providers to join one of the five voluntary payment models.
This week’s Medicare updates include the release of the 2020 ICD-10-CM codes, new voluntary appeals settlement options for inpatient rehabilitation facilities, updated instructions for organ transplant programs, and more!
The Revenue Integrity Symposium is the only conference I have seen that is packed with sessions that will give revenue integrity professionals practical information that they can take back and institute the next day to help their facility success financially.
CMS may have overpaid hospitals, physicians, and freestanding facilities almost $270 million for polysomnography services that did not meet Medicare requirements over a two-year period, according to an Office of Inspector General report.
