Billing Archives

Split-Shared Visit Revisited Next Year

David M. Glaser, Esq. November 9, 2022

CMS will delay until next year a final decision on this contentious issue. Every year, around this time, I feel a bit like Steve Martin

An Observation about Observation Rates (and Other Notes)

Ronald Hirsch, MD, FACP, CHCQM, CHRI November 2, 2022

Benchmark rates for observation depend on understanding your numerator and denominator. First up, a shout-out goes to my friend Dr. Charles Locke in Maryland, an

Hospital Pricing: Is the Price Always Right?

David M. Glaser, Esq. October 5, 2022

Healthcare pricing is a complicated minefield. A recent RACmonitor article written by Govind Goyal described enforcement of the price transparency rule. At the Chicago-Kansas City

Time is Not Always on My Side

Frank Cohen September 20, 2022

My Marine Corps father used to tell me that early was on time, on time was late and late was unacceptable. Time is truly a

Splitting Hairs: “Incident to” or Shared Visit

David M. Glaser, Esq. September 7, 2022

CMS has specific guidelines when defining “incident to” and shared visits. Recently, I was working with a client to help them understand “incident to” billing.

Issues and Implications: MedPAC to Benchmarks to KPIs

Ronald Hirsch, MD, FACP, CHCQM, CHRI June 29, 2022

Observations, questions and answers during a week of pontification. So what’s new this week? In a previous Monitor Monday, I mentioned the recently released 2022

The Challenges of Billing Observation Correctly

Ronald Hirsch, MD, FACP, CHCQM, CHRI June 16, 2022

Observation, outpatient outlier payments, and the Inpatient-only List: Getting it right is not always easy. On this week’s Monitor Mondays we had a robust discussion

The Challenges of Billing Observation Correctly

Ronald Hirsch, MD, FACP, CHCQM, CHRI June 8, 2022

Observation, outpatient outlier payments, and the Inpatient-Only List: Getting it right is not always easy. On this week’s Monitor Mondays we had a robust discussion

Readmissions and How They Affect Payments

Andrew Markiewitz MD, MBA-Healthcare May 11, 2022

Some flareups may lead to readmissions within 30 days. We can all agree that we want to fully treat our patients’ acute problems that require

Observation Volumes Continue to Stress U.S. Hospitals

Mary Beth Pace, RN, BSN, MBA, ACM, CMAC April 20, 2022

Observation billing for level of care is the strategy that insurance companies are using to hold their costs down. Whether you are part of a

MACs Misleading FAQs Frequently Go Unnoticed

David M. Glaser, Esq. April 6, 2022

Remember that just because a MAC says it, doesn’t mean it is true. It seems reasonable to expect Medicare Administrative Contractors (MACs) to make sure

Tread Carefully in Medicare Billing

Knicole C. Emanuel Esq. March 16, 2022

Thanks to new provisions that went into effect for the 2022 calendar year, CMS is no longer necessarily considering “nefarious intent” when determining whether a

Billing

Split-Shared Visit Revisited Next Year

An Observation about Observation Rates (and Other Notes)

Hospital Pricing: Is the Price Always Right?

Time is Not Always on My Side

Splitting Hairs: “Incident to” or Shared Visit

Issues and Implications: MedPAC to Benchmarks to KPIs

The Challenges of Billing Observation Correctly

The Challenges of Billing Observation Correctly

Readmissions and How They Affect Payments

Observation Volumes Continue to Stress U.S. Hospitals

MACs Misleading FAQs Frequently Go Unnoticed

Tread Carefully in Medicare Billing

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