August 1, 2020
Briefings on APCs

Judith L. Kares, JD, writes about the unique coverage, billing, and payment rules that apply to these blood products and related services under Part B.

August 10, 2020
News & Insights

Q: Are commercial payers allowed to conduct a pre- and post-payment review of the same claim?

July 15, 2020
News & Insights

CMS is planning to restart most Medicare fee-for-service medical reviews by August 3 regardless of the status of the public health emergency.

July 22, 2020
HIM Briefings

The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a rich source of data. Consider how to use the PEPPER to guide coding and CDI process improvements.

July 15, 2020
HIM Briefings

As commercial payer audits have increased, organizations have struggled to develop practical processes and consistent responses. Apply lessons learned from government audits to create processes that are unified and efficient.

June 1, 2020
Briefings on APCs

The American Hospital Association recently published a Coding Clinic Advisor FAQ regarding ICD-10-CM coding for the novel coronavirus (COVID-19). This article takes a closer look at the main topics addressed in the FAQ, including ICD-10-CM coding for COVID-19 antibody testing, virus signs and symptoms, and comorbidities.

June 1, 2020
Briefings on APCs

Determine the impact of new regulatory relief for hospitals regarding outpatient services and telehealth originating site services provided to patients at alternate locations, including their homes.

June 8, 2020
News & Insights

Q: How can we decide what risk areas should be the focus of auditing and monitoring?

June 24, 2020
HIM Briefings

Unintentional billing errors can occur even in the most vigilant organization. A comprehensive audit program can help detect these issues. Learn how to develop different types of audits to find and address errors.

May 1, 2020
Briefings on APCs

Navigating Medicare’s rules for charging for ancillary services, bedside procedures, and supplies is no easy task. Get an expert perspective on how to apply the rules.

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