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CMS incorrectly uses the term “observation.” As expected, the Centers for Medicare & Medicaid Services (CMS) released the 2023 Outpatient Prospective Payment System (OPPS) and
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
Common mistakes often include claim denials for failing to meet medical necessity. Observation services are an integral part of medical care provided in United States.
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
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
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
Observation status should be used until obtaining a diagnosis and treatment plan. C-Suites scrutinize utilization management programs when the observation metric increases. Investopedia defines metrics
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
Observation volumes continue to stress hospitals. The utilization process is very difficult and complicated. We must continue to advocate for our elders and
CMS says MOON errors will not affect billing/payment. EDITORS NOTE: This article is an update from last week’s article Erroneous Guidance by NGS Could Pose
Protecting patient rights is one of the cornerstones of Medicare policy. As a doctor, I can assure you that I would rather patients concentrate on
Concerns are related to observation claims. By now just about everyone has surely heard about Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma’s
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