There are 50 Shades of Grey in federal prepayment review. I hate wishy-washy laws. If a law exists, in my mind, it should be specific.
Although the Biden Administration claims this is the final regulation, there is evidence more is yet to come. The Biden administration released the final No
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
The prepayment review is the equivalency of the American legal tradition that holds “you’re guilty until proven innocent.” It’s hard enough to be one
Survey data suggests that hospital executives, physician advisors, and case managers are not always on the same page. Sound Physicians‘ recent nationwide survey provides insights
The proposed increase is approximately 2.8 percent. Hear ye, hear ye: there will be a Medicare reimbursement rate increase! On April 27, the Centers for
BPCI models require a working relationship between inpatient and outpatient settings. The federal Bundled Payments for Care Improvement (BPCI) initiative links reimbursement of services rendered
Program integrity at the Centers for Medicare & Medicaid Services (CMS) is under pressure to properly conduct Recovery Audit Contractor (RAC) and Medicare Administrative Contractor
HRSA is not a HIPAA-covered entity, so the official coding rules do not need to be followed when submitting claims. EDITOR’S NOTE: On this week’s
Back billing is key to remaining in business during COVID-19. One of the questions that I have heard repeatedly during the continuing COVID-19 pandemic was
Reimbursement for such services has grown during recent weeks. Many healthcare entities are facing tough economic times. There is a possible solution that benefits patients
The Chicago-area producers of the coveted new testing kits plan to generate 20 million units per month by June. EDITOR’S NOTE: During recent weeks, the
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