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.
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.
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.
As Medicare Advantage makes strides to becoming the new norm, organizations need to establish new processes, educate staff, and advocate for patients. Learn how your organization can keep pace with change before it’s too late to catch up.
HHS failed to meet targeted improper payment reductions for Medicaid and the Children’s Health Insurance Program and has not implemented a required recovery audit plan for Medicare Advantage, according to an Office of Inspector General (OIG) report.
A recent report released by the Centers for Disease Control and Prevention revealed that almost 70% of Americans are considered overweight or obese. This epidemic costs American healthcare systems approximately $190 billion per year in treatment of weight-related conditions.
When it comes to dealing with Medicare Recovery Auditors (RACs), there is never a dull moment for HIM professionals. Any shift in the RAC program quickly emerges as front-page news for HIM leaders.
Managers should not assume that they can review every guideline, every item in Coding Clinic, or every coding-related issue targeted by the Office of Inspector General or Recovery Auditor.
This week’s Medicare updates include the final Medicare Outpatient Observation Notice (MOON), a CY 2017 Update to the DMEPOS fee schedule, information on the CJR Model Skilled SNF 3-Day Rule Waiver, and more!
