The Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction proposed rule would make significant changes to the Conditions of Participation and could change the way hospitals work with competitive ambulatory surgery centers (ASC).
As hospitals transform from volume-based to value-based reimbursement, the role and functions of the utilization review (UR) committee are evolving. Learn how to refocus UR and use it as a tool for success now and in the future.
The Revenue Integrity Symposium (RIS) is such an important event to anyone in the revenue integrity profession because while there are many conferences that touch upon aspects of revenue integrity, RIS is the only one entirely dedicated to that topic.
Implementing a denial avoidance initiative can help facilities and health systems realize lost revenue, achieve cost savings, and improve an organization’s financial performance.
Inappropriate use of nonemergency ambulance transport cost Medicare $8.7 million in overpayments, according to a recent Office of Inspector General (OIG) report.
CMS recently released new documentation guidance on medical review of E/M services performed by medical students. A medical student may document E/M services if the physician performs or re-performs the exam and then verifies the student’s documentation.
Many HIM directors find that managing the coding team requires a different type of focus than other functions within the department. This may be true because coding professionals have advanced education, prefer a quiet work environment, and require less direction.
Although regulatory agencies have not banned the use of medical scribes, organizations must follow certain requirements. Learn how to define the scribe’s role and responsibilities and ensure that documentation is correctly certified.
The nearly 30-year-old Stark Law could be due for an overhaul, according to CMS. The agency is requesting public feedback on how to streamline the law’s administrative requirements and retool it to better fit with modern alternative payment models and value-based care.
