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.
This week’s updates include October quarterly update to 2016 annual update of HCPCS codes used for SNF Consolidated Billing enforcement; OIG investigation into improper arrangements and conduct involving home health agencies and physicians; and more!
The Commission for Case Manager Certification and the National Association of Social Workers entered an agreement to offer more social workers a chance at earning the Certified Case Manager® credential.
The Commission for Case Manager Certification and the National Association of Social Workers entered an agreement to offer more social workers a chance at earning the Certified Case Manager® credential.
CMS' coding modifiers are not always used to report clinical components of a service. Sometimes they can be used in order to provide information about how a service relates to Medicare coverage policies.
The average data breach costs an organization nearly $4 million per incident, according to a study sponsored by IBM and conducted by the Ponemon Institute. Costs are higher than the average for organizations in highly regulated industries such as healthcare.
CMS issued a final rule last week to revamp the way it pays for tests under the Clinical Laboratory Fee Schedule (CLFS), though the agency has pushed the start date back a year and worked to ease administrative burden based on public comments.
Risk-adjustment documentation can be based on records from hospital inpatient, hospital outpatient, and provider services. Although CDI is firmly rooted in inpatient services, now it can extend to outpatient and even professional services. As more hospital systems purchase physician practices, there is increasing interest outside just inpatient documentation.
