Editor's note: Andrea Clark-Rubinowitz, RHIA, CCS, CPCH, has more than 30 years of experience working with healthcare professionals, information systems, hospital coding, and operational and compliance training. She founded and led Healthcare Revenue Assurance Associates from 2001 to 2014. Contact her at 954-465-0968 or aclark5678@gmail.com.
CMS has instructed MACs to reprocess claims and providers to reimburse beneficiaries due to a miscalculated copayment for stereotactic radiosurgery, according to the October update to the OPPS and Integrated Outpatient Code Editor (I/OCE).
The hospital/health system revenue cycle has a significant role in hospital billing compliance. The billing department is the final gatekeeper for compliance, as it is the final area to touch a bill before it is sent to Medicare. Therefore, it is essential that billing staff understand key compliance risk areas.
To fully understand where your organization's risks lie, you not only need to have a firm grasp on risk analysis and assessment processes, you need to define these processes as well.
This week’s updates include updated information on the hospital appeals settlement offer and adjustments to amount in controversy threshold for CY 2015. Click the link above to read more about this week’s updates.
