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.
The Hierarchical Condition Categories (HCC) risk-adjustment methodology is beginning to surface more frequently in both the acute and primary settings. Use these expert tips to help improve complete, compliant HCC capture.
When evaluating a code edit, it’s necessary to understand exactly when or where in the claim or billing process the edit arose. Look to coding guidance to help edit resolution efforts.
Although compliant querying is clearly spelled out in inpatient CDI, where patient encounters can last three to five days, it’s more complex in the fast-paced ambulatory world where single patient encounters are shorter and may be spread over a year’s time. Experts weigh in on the best approach to effective, compliant outpatient queries.
