The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is key to revenue integrity success. Understanding its benefits and limits is important for any successful revenue integrity program.
This week's note from the instructor addresses some of the issues arising from the start of a new Quality Improvement Organization (QIO) contracting cycle.
Accountable care organizations (ACO) avoid downside risk contracts even though the number of ACO contracts and ACOs with multiple contracts have grown, according to a recent study. The study authors suggest that stronger incentives to take on downside risk are necessary to ensure the success of the ACO model.
This week’s Medicare updates include a decision memo for an ambulatory blood pressure monitoring NCD, another extension of enforcement discretion for the laboratory date of service exception policy, a fact sheet on proper billing processes for DMEPOS items delivered to inpatients, and more!
