Hospital and health system revenue cycle vice presidents and directors will once again meet to —review these strategies and new ones at the 2018 HealthLeaders Media Revenue Cycle Exchange, March 21-23 at Ponte Vedra Beach, Florida. To learn if you qualify for the invitation-only event, please contact Exchange@healthleadersmedia.com.
According to a report published by Change Healthcare, 23.9% of claim denials are due to errors during front-end revenue cycle processes such as registration and eligibility.
Root cause analysis of edits and an understanding of the relationship between the chargemaster and HIM/coding must be supported by overarching principles and best practices for edit management. Processes should be built around the timing of edits, applying edits across payers, and denial management.
Providers in some states may soon discover a big hurdle to clear when seeking to report a set of apheresis services after one MAC tightened up physician supervision requirements.
The Office of Inspector General found CMS improperly awarded an estimated $4.6 million in reimbursement for immunosuppressive drugs billed with modifier -KX (requirements specified in the medical policy have been met). The OIG also said CMS should revise guidance on modifier -KX because current guidance is confusing and contradictory.
As CMS and third-party payers have looked for ways to treat patients in the outpatient setting and reduce inpatient volumes, CMS has used the 2-midnight rule, in addition to other methods, to treat patients as outpatients or in observation whenever possible.
The Joint Commission continues to provide excellent resources to help healthcare organizations stay ready for surveys, as well as resources that help them meet and understand the intent of standards and elements of performance.
When it comes to dealing with Medicare Recovery Auditors (RACs), there is never a dull moment for HIM professionals. Any shift in the RAC program quickly emerges as front-page news for HIM leaders.
