Revenue cycle leaders can fall into a trap of merely managing problems that pop up. But the danger with a “fix it” approach is that so many of the challenges in revenue cycle are connected.
Q: Are we required to explain why a vulnerability was not addressed or was deemed low priority in the risk management plan? If so, are there any examples of acceptable ways to document this per OCR?
This week’s note explores the newly expanded national targeted probe and educate initiative with a focus on how processes for the program should work and what providers can do to simplify the review period.
This week’s Medicare updates include a fact sheet on the transition to new Medicare cards, a table to clarify alternative payment models’ statuses in the Quality Payment Program, a review of a health system’s compliance with inpatient rehabilitation facility service billing requirements, and more!
The implementation of an EHR is a multifaceted, comprehensive project for healthcare organizations. To avoid coding issues during EHR implementation and ensure discharged-not-final-coded is not adversely impacted, dedicated HIM focus and detailed project planning are paramount.
An OIG audit of the University of Michigan Health System revealed noncompliance with four types of inpatient claims, including those associated with billing of DRGs, and two types of outpatient claims, including those billed with modifier –59 (distinct procedural service).