November 29, 2016
Medicare Insider

This week’s Medicare updates include a claims status category and claims status codes update, new waived tests, the reprocessing of some IPPS claims, and more!

November 29, 2016
News & Insights

This week’s note discusses updates to Medicare beneficiary cost sharing for 2017.

November 22, 2016
Medicare Insider

This week’s Medicare updates include 2017 Annual Update to the Therapy Code List, a Proposed Decision Memo on Leadless Pacemakers, Provider Reimbursement Manual Hospital and Hospital Health Care Complex Cost Report Form CMS-2552-10 updates, and more!

November 21, 2016
News & Insights

Hospitals with pending appeals before an administrative law judge or the departmental appeals board may see some relief. Eligible providers can settle denied inpatient claims that are currently under review for 66% of the net allowable amount in exchange for withdrawing certain pending appeals under the 2016 Hospital Appeals Settlement Process.

November 18, 2016
News & Insights

CMS removed seven codes from the inpatient-only list in the 2017 OPPS final rule, but decided not to change the designation of a code involved with several of the agency’s bundled payment models.  

November 15, 2016
Medicare Insider

This week’s Medicare updates include the release of the OIG 2017 Work Plan, a CMS memorandum regarding noncompliance of transplant centers, an OIG report on unallowable claims for outpatient physical therapy services, and more!

November 1, 2016
Briefings on APCs

Orders for services are a vital component of ensuring Medicare coverage. With the advent of computerized provider order entry (CPOE), it is important to review order templates in the electronic medical record (EMR) and the resulting order produced or printed in the formal legal medical record to ensure the templates meet requirements.

November 1, 2016
Briefings on APCs

With only 60 days between the OPPS final rule's release and the January 1 implementation date, providers will be ahead of the curve by spending time now and thinking about the processes they may need to review, change, or implement based on what CMS finalizes and the sort of financial impact the final rule is likely to have.

November 1, 2016
Briefings on APCs

Just like the lyrics to the popular Gap Band song say, "You dropped a bomb on me… I won't forget it," there are definitely some changes in the 2017 ICD-10-CM Official Guidelines for Coding and Reporting that some of us may wish the Cooperating Parties will forget were ever mentioned.

November 8, 2016
Medicare Insider

This week’s Medicare updates include the release of the End-Stage Renal Disease Prospective Payment System final rule, an announcement of the next round of Medicare Recovery Audit Contractors, the Hospital Outpatient Prospective Payment Changes for 2017 final rule, CY 2017 Home Health Prospective Payment System, a Hospital Appeals Settlement Update, and more!

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