News & Analysis

June 19, 2024
Briefings on APCs

Make sure staff who handle audit requests understand when a missing signature should — or should not — trigger an automatic denial of your claims or prior authorization requests. Recent guidance from CMS clarifies how auditors should proceed when a medical record lacks a signature.

March 27, 2024
Case Management Monthly

A final rule issued by CMS in February includes several changes to Medicare Advantage (MA) regulations aimed at ensuring health equity, quality, and safety.

September 20, 2023
Briefings on APCs

When writing appeals for healthcare denials, being proactive and thorough can significantly improve the chances of overturning the denials.

September 1, 2021
Case Management Monthly

Audits are ramping up across the country, creating additional headaches for many healthcare organizations as they simultaneously struggle with the delta variant of COVID-19.

August 4, 2020
Medicare Web

Facing the unprecedented COVID-19 public health emergency, CMS released the 2021 OPPS proposed rule later than ever before, with the agency generally reinforcing its recent focus on site-neutral payment policies, lowering reimbursement for drugs purchased under the 340B program, and adding more services to the list of prior authorization. 

January 22, 2020
HIM Briefings

Conflicting provider documentation can raise red flags for auditors and slow down coding. Learn about common causes of conflicting documentation and strategies to reduce its occurrence.

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