The numbers are in and some 12.7 million Americans signed up for a health plan during the Health Insurance Marketplaces open enrollment period. Some 9.6 million people enrolled through HealthCare.gov and 3.1 million through marketplaces in their home state.
The addition of thousands of new diagnosis and procedure codes in a single year might typically be cause for concern for hospitals, with ICD-9-CM updates before the 2012 code freeze rarely topping more than a couple hundred per year.
Providers must generally be enrolled in the Medicare Fee-for-Service Program in order to receive payment for otherwise covered Medicare services. The relevant enrollment requirements may vary, depending upon the type of provider.
Q: In an outpatient hospital setting, if a patient goes to the floor post-surgery, and the same drugs are continued on the floor, can we charge for their administration?
This week’s updates include Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the physician fee schedule, and criteria for physician-focused payment models; early implementation results for enhanced enrollment screening of Medicare providers; and more!
Cornerstone Hospital of Bossier City, Louisiana, incorrectly billed Medicare for all claims with a diagnosis of kwashiorkor and received $321,971 in overpayments during a five-year period,
