The 2023 Inpatient Prospective Payment System (IPPS) final rule includes a welcome payment rate increase, coding updates, and adjustments to quality and reporting programs. Review the major provisions of the rule to ensure your organization is in compliance.
The variety of sources for commercial insurance requirements can present challenges to the utilization review (UR) specialist, as UR rules for every patient could differ depending on his or her insurance and that insurer’s policies. Apply these lessons to help UR manage commercial insurance requirements.
Critical access hospitals (CAH) and rural health clinics (RHC) provide vital services to their communities, but even in the best of times they can face serious revenue challenges. Ensure these vital facilities are supported by correct, complete billing practices.
Debridement is the medical removal of dead, damaged, or infected tissue from a wound to improve healing. Review the different types of debridement and the associated documentation and coding requirements.
CDI audits are crucial to helping staff keep up with changing guidelines and best practices. Use these tips to turn audits into a powerful teaching tool.
Although the inpatient-only list has evolved over the years it's remained a common source of easily avoidable denials. Brush up on the details of the requirement to improve compliance at your organization.
Bronchoscopy is a procedure that allows a pulmonologist to assess the lungs and air passages. Review ICD-10-PCS coding for bronchoscopy with bronchoalveolar lavage and suction of a mucus plug.
The revenue cycle produces a wealth of data but connecting the dots between disparate datasets is a challenge. Consider these methods to evaluate tools to manage revenue cycle data.
