The government may finally have to comply with its congressionally mandated deadlines for reviewing claims at the Administrative Law Judge level after a federal appeals court this week reversed a lower court’s dismissal of a lawsuit brought by hospitals.
Developing a strong denial management program may be one of the best ways to minimize the productivity and financial losses anticipated with the transition to ICD-10. By determining a baseline for denials and proactively identifying denial trends, organizations can efficiently resolve issues and reduce costs. An effective denial management program will help organizations to track, trend, resolve, and ultimately prevent denials.
This week CMS released guidance on the new Place of Service (POS) code for off-campus provider-based facilities, the 2-Midnight Rule, and appeals of claims denied by post-payment review contractors. Each item is short, but provides information on topics important to providers and physicians.
On January 31, CMS announced on its Inpatient Hospital Reviews website that it extended the probe and educate period for implementation of the 2-midnight benchmark through September 30, 2014. Along with the announcement of the extension, it also released an updated version of the guidance documents on inpatient hospital reviews and on the new order and certification requirements. Click the link above for more information and an in-depth analysis.
This week’s note is about new rules regarding contractors up coding or down coding. Click the link above for more information and an in-depth analysis.
