The American Hospital Association and several other hospital groups released a joint statement criticizing CMS’ proposed price transparency policy outlined in the calendar year 2020 OPPS proposed rule that would require hospitals to publish negotiated rates with private payers.
While there are many conferences that touch upon aspects of revenue integrity, RIS is the only one entirely dedicated to the topic. Plus, it is a great way to meet other professionals in the field of revenue integrity who are facing similar challenges and have similar interests.
CMS is proposing several revisions to its clinical diagnostic laboratory date of service (DOS) policy in the FY 2020 OPPS proposed rule, including requiring ordering physicians to determine whether tests are intended to guide treatment during a current or future outpatient encounter.
Starting January 1, 2020, the education and operations testing period will kick off, and organizations will be required to report appropriate use criteria (AUC) consultation information. Learn what you can do now to help your organization prepare to report AUCs in 2020 and beyond.
Even if a hospital is not a teaching hospital, it may have services that require National Clinical Trial (NCT) reporting. It is logical for revenue integrity leadership to own this issue, but an explanation of the requirements for NCT reporting should be shared with all staff within the revenue cycle so there is a better appreciation of the fact that clinical trial billing rules apply more broadly than merely just to research or clinical trial studies.
Q: We have a case in which there was an observation order for a patient with Medicare Part B as a primary insurance and Cigna as a secondary insurance. If this is billed to Medicare and denied, can the secondary insurance be billed?
CMS released the 2020 OPPS proposed rule July 29, proposing to refine previous policies related to price transparency and the 2-midnight rule, while also asking for comments on how to potentially undo its policy that reduced payments for drugs purchased under the 340B drug discount program by nearly 30%.
CMS recently announced that it updated the national coverage policy for transcatheter aortic valve replacement (TAVR), requiring covered hospitals and physicians to begin or maintain a TAVR program and adhere to updated volume requirements.
The January 1, 2020, deadline for reporting Appropriate Use Criteria (AUC) for advanced diagnostic imaging is fast approaching—but organizations can’t wait until the new year to prepare.
Past Revenue Integrity Symposium (RIS) attendees and speakers agree: It’s a can’t-miss event for revenue integrity education and networking. The best part? Savvy revenue integrity professionals can take advantage of several ways to save on the cost of attendance, scoring premier education without breaking the budget.
