Providers often struggle with finding a solid definition of “not medically necessary.” Understanding the coverage definitions from the perspective of the payer, as well as how to stay current with guidelines, may help facilities improve billing practice when this common issue is involved.
Nearly 20% of patients involved in a recent UT Southwestern Medical Center study were discharged from the hospital with one or more unstable vital signs, resulting in a higher number of deaths or readmissions than patients discharged with stable vital signs.
A Virginia dermatology clinic notified 13,237 patients this month of a breach of protected health information (PHI) in the wake of a ransomware attack.
CMS’ wireless network has significant vulnerabilities that could compromise the integrity of the agency's data, the Office of Inspector General (OIG) said in a recent report.
CMS did not have a choice about implementing site-neutral payment policies after Congress passed Section 603 of the Bipartisan Budget Act of 2015, but providers hope the agency will reconsider some of the provisions to operationalize the policy introduced in the 2017 OPPS proposed rule.
Q: I have a question about navigating the skilled nursing facility (SNF) benefit for Medicare. My understanding is that you can only use a Hospital-Issued Notices of Noncoverage (HINN) for inpatient, so you could use if less than a three-day stay. We have been giving Advance Beneficiary Notices (ABN) for our traditional Medicare patients that are observation when families are not timely on getting a SNF secured to those patients that require it. Is this correct?
The Medicare Reporting and Returning of Self-Identified Overpayments final rule became effective March 14 and applies to healthcare “providers” and “suppliers” furnishing services under Medicare Parts A and B. This article explains some of the key points in this rule.
