News & Analysis

July 8, 2016
Medicare Web

CMS proposes aligning its conditional packaging modifiers and deleting a much-maligned modifier for separately payable laboratory tests in the 2017 OPPS proposed rule, released July 6. 

June 27, 2016
Medicare Insider

The 2016 Revenue Integrity Symposium brings together training on Medicare billing and compliance, case management, revenue integrity, coding, CDI, and patient status, and more.

April 1, 2016
Briefings on APCs

The new modifier -PO (services, procedures, and/or surgeries furnished at off-campus provider-based outpatient departments [PBD]) and the alternative payment provisions under the Bipartisan Budget Act Section 603 are both related to off-campus PBDs but define "off-campus PBD" slightly differently.

January 27, 2016
Medicare Insider

This week we will continue our discussion on several Medicare processes involving changes to claims as originally submitted and/or adjudicated. We will review the five-level Medicare appeals process (Appeals Process) and the relationship of that process to claim adjustments (Adjustments) and reopenings (Reopenings).

January 14, 2016
Medicare Insider

This week’s note is about updates to the process of claims adjustments and reopenings.

October 1, 2015
HIM Briefings

Developing a strong denial management program may be one of the best ways to minimize the productivity and financial losses anticipated with the transition to ICD-10. By determining a baseline for denials and proactively identifying denial trends, organizations can efficiently resolve issues and reduce costs. An effective denial management program will help organizations to track, trend, resolve, and ultimately prevent denials.