News & Analysis

August 12, 2019
Medicare Web

Q: What is the difference between a Medicare claim appeal (redeterminiation) versus reopening of a claim?

July 30, 2019
Medicare Web

CMS released the 2020 OPPS proposed rule July 29, proposing to refine previous policies related to price transparency and the 2-midnight rule, while also asking for comments on how to potentially undo its policy that reduced payments for drugs purchased under the 340B drug discount program by nearly 30%.

July 26, 2019
Medicare Web

Facilities need to know how to respond to documentation requests as part of any Medicare audit or review. Preparing a complete and proper reply makes all the difference in the outcome or results of those audits and reviews.

July 25, 2019
Medicare Web

Past Revenue Integrity Symposium (RIS) attendees and speakers agree: It’s a can’t-miss event for revenue integrity education and networking. The best part? Savvy revenue integrity professionals can take advantage of several ways to save on the cost of attendance, scoring premier education without breaking the budget.

July 8, 2019
Medicare Web

Q: What are Medicare's criteria for reopening a claim as opposed to treating it as a denial?

July 1, 2019
Briefings on APCs

In 2013, “Guidelines for Achieving a Compliant Query Practice,” a collaboration between AHIMA and ACDIS, was published. It has served as the industry guideline for the establishment of best practices surrounding queries. The 2019 update reinforces the information set forth in the preceding practice briefs while also introducing some newer guidelines reflective of today’s healthcare environment.