Being audited is rarely fun. After all, you're probably going to lose money, face a fine, or both. More and more entities are auditing healthcare claims-Recovery Auditors, Medicare Integrity Contractors, MACs, FIs, commercial payers, and on and on.
Editor's note: Facilities need to address coding, payment, and coverage issues for molecular pathology. This article is the first in a series and discusses molecular pathology coding.
CMS is making a significant change to the Medically Unlikely Edits (MUE) by changing some of them from line-item edits to date-of-service (DOS) edits, effective April 1.
There has been some confusion surrounding a possible Recovery Auditor-related provision in the American Taxpayer Relief Act of 2012, also known as the fiscal cliff deal.
St. Joseph's Medical Center in Towson, Md., reached a settlement with the United States to pay $4.9 million in connection with its submission of false claims to Medicare, Medicaid, and other federal healthcare programs, announced the Justice Department on February 7.
Although the results of the Ponemon Institute's Third Annual Benchmark Study on Patient Privacy & Data Security don't paint a pretty picture when it comes to protection of PHI, healthcare organizations can use the dismal statistics to improve compliance.
