Connolly posts 25 new issues across five categories
Connolly Healthcare added 25 new issues across five categories—13 for carrier claims, three for DME claims, seven for outpatient claims, one for medical necessity claims, and one for home health...
View ArticleHealthDataInsights posts 12 new issues across five categories
HealthDataInsights added three 12 issues across five categories—three for other carrier/biller claims, three for physician claims, three for supplies claims, two for acute care claims and one for...
View ArticleTwo new steps toward pay for performance for Part A inpatient hospital...
Editor’s note: Judith Kares, JD, CPC, regulatory specialist for HCPro, Inc., is the author of this week’s note from the instructor. During the last two Notes, Kimberly Hoy focused on the manualization...
View ArticleImportant Medicare updates
HHS issues omnibus HIPAA final rule On January 25, HHS issued in the Federal Register the omnibus HIPAA final rule. View the final rule. View an HCPro breakdown. CMS issues NCA for bariatric surgery...
View ArticleClarifying the Recovery Auditor-related provisions in the American Taxpayer...
by Ralph Wuebker, MD, MBA, Chief Medical Officer, Executive Health Resources There has been some confusion surrounding a possible Recovery Auditor-related provision in the American Taxpayer Relief Act...
View ArticleNote from the instructor: Two new steps toward pay for performance for Part A...
Editor’s note: This is the second of a two-part series of articles that focuses on two new quality initiatives—the HRRP and the VBPP– also discussed in the above-noted transmittal that will impact...
View ArticlePerformant Recovery posts 23 new issues across seven categories
Performant Recovery added 23 new issues across two categories—Eleven for physician/nonphysician practitioner claims, seven for outpatient hospital claims, and one each for laboratory claims, CAH...
View ArticleConnolly posts 30 new issues across four categories
Connolly Healthcare added 30 new issues across four categories—12 for medical necessity claims, nine for carrier claims, eight for outpatient hospital claims, and one for hospice claims— to its...
View ArticleTherapy caps revisited
Editor’s note: Debbie Mackaman, RHIA CHCO, regulatory specialist for HCPro, Inc., is the author of this week’s note from the instructor. After the American Taxpayer Relief Act of 2012 (ATRA) was signed...
View ArticlePhysician Queries AHIMA/ACDIS guidelines: Tools to ensure compliance
Learn the latest rules governing physician query practices from two experts who contributed to the new ACDIS/AHIMA query practice brief. A lack of accurate or complete documentation can result in...
View ArticleAudio conference: Three-day payment window
How does your facility determine which services are directly related to the admission and fall into the three-day payment window? On January 4th, CMS updated the three-day payment window section of the...
View ArticleConnolly posts two new issues for outpatient hospital claims
Connolly Healthcare added two new issues for outpatient hospital claims to its CMS-approved list for providers in Region C states. (See link for individual state applicability.) According to the...
View ArticleCMS issues proposed regulations to implement medical loss ratio requirements...
Editor’s note: Judith Kares, JD, CPC, regulatory specialist for HCPro, Inc., is the author of this week’s note from the instructor. Congress enacted the Affordable Care Act (the “ACA”) in March, 2010,...
View ArticleNew! Revenue Cycle Institute releases ICD-10-PCS Procedure Guidelines White...
The Revenue Cycle Institute has released a new white paper, “ICD-10-PCS Introduces Procedure Guidelines and Coder Confusion,” by Jennifer Avery, CCS, CPC-H, CPC, CPC-I , regulatory specialist for...
View ArticlePerformant Recovery posts four new issues across three categories
Performant Recovery added four new issues across three categories—Two for outpatient hospital claims, one for physician/nonphysician practitioner claims, and one for DME claims—to its CMS-approved list...
View ArticleNew! Revenue Cycle Institute releases 2013 Recovery Auditor Benchmarking Report
The Revenue Cycle Institute has released a new white paper, “2013 Recovery Auditor Benchmarking Report,” by Debbie Mackaman, RHIA, CHCO, Director of Medicare and compliance for HCPro, Inc. To download...
View ArticleCMS issues proposed changes to Part B inpatient billing in hospitals
On March 13, CMS issued a notice of ruling that establishes a policy that revises the current policy on Part B billing following the denial of a Part A inpatient hospital claim that a Medicare review...
View ArticleMultiple departments affected by April OPPS changes
Editor’s note: Kimberly Anderwood Hoy, JD, CPC, director of Medicare and compliance for HCPro, Inc., is the author of this week’s note from the instructor. The second quarter is not normally an...
View ArticleHCPro announces fifth annual Medicare Compliance Forum
Medicare Compliance Forum was created to help you discover practical approaches to addressing important Medicare compliance, as well as Medicare revenue cycle concerns. This program will help you...
View ArticleCMS continues to provide updates on the Medicare and Medicaid EHR Incentive...
Editor’s note: Judith Kares, JD, CPC, regulatory specialist for HCPro, Inc., is the author of this week’s note from the instructor. To keep eligible professionals, hospitals and critical access...
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