This week’s Medicare updates include several corrections to transmittals issued regarding April 2018 payment system updates, four new resources for those participating in the Quality Payment Program via an alternative payment model, an OIG review of outpatient physical therapy billing, and more!
Preventive care is an essential component of rural health clinic services, but Medicare's coverage and billing rules for these services—including annual exams and vaccines—can be complicated to navigate.
Many hospitals find that their Patient Safety Indicator (PSI) ratios remain high despite doing a spectacular job of addressing these events and exclusions. That may be because they fail to realize that the Agency for Healthcare Research and Quality has a risk-adjustment methodology that predicts each of these PSIs and is dependent upon the documentation and coding of PSI-sensitive risk factors.
Cardiac device credits came under scrutiny in an Office of Inspector General report that found all 210 hospitals audited failed to adjust claims to reflect certain cardiac device manufacturer credits, leading to $4.4 million in overpayments from CMS.
In today’s uncertain regulatory environment, establishing an internal audit process is more important than ever to ensure proper billing and reimbursement. Follow these eight steps to establish an efficient internal audit and compliance program.
This week’s Medicare updates include a special edition MLN Matters article on billing requirements for OPPS providers, an updated OIG work plan, a final decision memo for an NCD on genetic testing for cancer patients, and more!
