My understanding is that under the 2-midnight rule CAHs cannot go past two midnights of observation care if the patient has Medicare as a payer. Is that correct?
My understanding is that under the 2-midnight rule CAHs cannot go past two midnights of observation care if the patient has Medicare as a payer. Is that correct?
CMS is looking to implement the Section 603 provisions of the Bipartisan Budget Act of 2015 regarding off-campus, provider-based departments by January 1, 2017, according to the 2017 OPPS proposed rule, released yesterday.
In this excerpt from Inpatient-Only Procedures Training Handbook, written by Debbie Mackaman, RHIA, CPCO, CCDS, inpatient order requirements and common difficulties encountered when dealing with inpatient-only procedures are discussed.
This week’s updates include new waived tests; appeals of claims decisions, revisions to timeliness requirements for forwarding misfiled appeal requests, reconsideration request form, and guidelines for writing appeals correspondence; and more!
CMS has proposed changes to reduce its massive Medicare appeals backlog, which has been the subject of lawsuits and a recent Government Accountability Office report, with the goal of clearing outstanding appeals by 2021.
Q: We operate a partial hospitalization program (PHP) and just heard from our billing office that there are new requirements for submitting claims. They want us to close out accounts weekly in order for them to bill them. We have done 30-day accounts prior to this and don’t see why they want to change things. Is there a certain timeframe required for billing these services? This is a huge inconvenience to make this work for the business office.
The OIG’s Work Plan Mid-year Update is a summary of new and ongoing OIG reviews and activities. During FY 2016, it has focused its Medicare oversight efforts on identifying and offering recommendations to reduce improper payments, prevent and deter fraud, and foster economical payment policies.
