July 8, 2019
News & Insights

Q: What are Medicare's criteria for reopening a claim as opposed to treating it as a denial?

July 3, 2019
News & Insights

Anne Arundel Medical Center in Annapolis, Maryland, will pay $3,154,000 to settle allegations that it submitted false claims to Medicare for medically unnecessary evaluation and management services and separately billing bundled procedures

July 3, 2019
Medicare Insider

This week’s Medicare updates include a policy clarification regarding negative wound therapy, an executive order on price transparency, and more! 

July 1, 2019
Briefings on APCs

CMS recently released two quarterly updates effective July 1: Medicare Claims Processing Transmittal 4313, which is the July update to the OPPS, and Medicare Claims Processing Transmittal 4314, which is the related July update to the Integrated Outpatient Code Editor (I/OCE) Specifications, Attachment B.

July 1, 2019
News & Insights

CMS recently agreed to settle an ongoing dispute with inpatient rehabilitation facilities (IRF) over the backlog of denied Medicare claims.

June 26, 2019
News & Insights

Most proposed solutions to surprise medical bills will negatively affect provider organizations, according to a Moody’s Investors Report released June 20. However, even in the absence of a solution, the growing awareness of the scope and impact of surprise medical bills will harm providers’ relationships with patients.

June 28, 2019
News & Insights

The Revenue Integrity Symposium is filled with so much information that applies to all levels of revenue integrity from those of us in the trenches to management. It will be my third year attending and I’m still finding new sessions to attend. And the networking is amazing!

June 24, 2019
News & Insights

The CDC has posted the FY2020 ICD-CM final code changes, and there were no changes to the proposed list of 273 new, 30 revised and 21 invalidated codes that were released in the proposed inpatient hospital prospective payment system rule, April 23.

June 24, 2019
News & Insights

Q: My team is asking me if we should combine pre-admission testing (PAT) visits with the surgery bill. I'm thinking no because some of the PAT services are not routine for the surgery. However, isn't there a rule about services that can't be billed separately prior to surgery?

June 21, 2019
News & Insights

The Revenue Integrity Symposium is the only conference I have seen that is packed with sessions that will give revenue integrity professionals practical information that they can take back and institute the next day to help their facility success financially.

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