The OIG claimed that 71 of 333 inpatient claims did not meet Medicare criteria for inpatient status. A recent report, titled “CMS Can Use OIG
Avoidable days can impact patient care and social determinants of health (SDoH). I always love working in the hospital with my fellow case managers, because
Be prepared for audits of inpatient hospitalizations with explanations of attempted prevention. The Centers for Medicare & Medicaid Services (CMS) and its contracted auditors are
A longtime RACmonitor contributor has three different topics on his mind this week. Let’s start with the good news. It looks like we will be
Often, the ability to move such a patient from the hospital into an appropriate setting is dependent on the social services in the local jurisdiction.
CMS has implemented two measures under its Hospital Inpatient Quality Reporting program. There is a lot of buzz in the Social Determinants of Health (SDoH)
How to stay compliant with code 44. This is certainly a topic that could result in literally hours of presenting, as there is a lot
Do you keep them under inpatient status? Or do you bring them in as outpatients and just keep them overnight? For our Medicare populations, in
When is a patient an inpatient? A reader we’ll call Michelle asked a question during a recent Monitor Mondays broadcast — a question that encapsulated
Observation volumes continue to stress hospitals. The utilization process is very difficult and complicated. We must continue to advocate for our elders and
Summary highlights from the ACPA’s NPAC 2021 conference: “Advising in an Unconventional World.” The Centers for Medicare & Medicaid Services (CMS) continues to create confusion
In an unprecedented move, the Centers for Medicare & Medicaid Services (CMS) has proposed in the 2022 Outpatient Prospective Payment System (OPPS) Rule to put
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