The HIM department plays a critical role in the revenue cycle, but it’s often placed in a reactive position, limiting its effectiveness. Learn how to improve operations by enhancing the HIM department’s involvement across the revenue cycle.
Q: How does CMS define a "shoppable service"? What information needs to be included in the list of 300 shoppable services required by the Hospital Price Transparency final rule?
CMS' new final rule prepares for vaccine coverage for Medicare, Medicaid, and commercial insurers without any out-of-pocket costs. CMS will pay for any coronavirus vaccine that receives FDA authorization either through an Emergency Use Authorization or via a license under a Biologics License Application.
CMS finalized the long-awaited Stark Law final rule on November 20. The final rule includes significant changes to exceptions to the law as well as expanded guidance and clarification.
The Office of Inspector General (OIG) is planning to audit hospital inpatient claims for compliance with the 2-midnight rule, according to a recent update to its Work Plan.
Q: For the purposes of determining a Medicare overpayment, should claims that we are uncertain whether they were appropriate be included? Is this defined under the False Claims Act (FCA)?
