One of the most memorable sessions at the AMA CPT Symposium in November 2017 involved an impromptu open mic feedback session facilitated by CMS’ Marge Watchorn, deputy director of the Division of Practitioner Services. The focus of this session was the applicability of the current CMS documentation guidelines for E/M services.
In the current healthcare climate, the issue of medical necessity documentation, or lack thereof, is one of the most common reasons for claim denials. For a service to be considered medically necessary (by a third-party payer), it must be considered a reasonable and necessary service to diagnose and/or treat a patient’s current and/or chronic medical condition.
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.
At the start of 2018, it’s time to take stock of billing compliance risks that may affect your organization in the new year and patch potential holes before they become a problem.
The National Association of Healthcare Revenue Integrity is currently seeking speakers to present at the 2018 Revenue Integrity Symposium, to be held October 16–17, 2018, in Litchfield Park, Arizona. Is that special person you or a colleague?
A recent OIG audit and report revealed that Medicare incorrectly paid approximately $1.7 million to Carolinas Medical Center in Charlotte, North Carolina, as a result of incorrect billing on the part of the medical center.
Hospital and health system revenue cycle vice presidents and directors will once again meet to —review these strategies and new ones at the 2018 HealthLeaders Media Revenue Cycle Exchange, March 21-23 at Ponte Vedra Beach, Florida. To learn if you qualify for the invitation-only event, please contact Exchange@healthleadersmedia.com.
The term and concept of revenue integrity began emerging early in the 21st Century. This emergence was partly in response to concerns that phrases such as maximizing and optimizing revenue might imply gaming or failure to comply with regulations, laws, and business ethics.
