According to the American Hospital Association’s (AHA) 2015 fourth quarter RACTrac survey, which included nearly 750 hospitals, shows that 81% of complex denials in the fourth quarter were due to inpatient coding errors—falling between the second quarter (79%), and third quarter (83%)...Read More »
Nearly 700 rural hospitals are at risk of closure, according to a report from iVantage Analytics. Rural or critical access hospitals (CAHs) provide care to about 11.7 million people, employ 100,000 healthcare workers, and account for $277 billion in economic activity. Yet the report shows that...Read More »
Even though Promise Hospital of Ascension, a 54-bed transitional care hospital located in Gonzales, Louisiana, closed before the Office of the Inspector General (OIG) began auditing it for fraudulent Kwashiorkor claims, the agency found errors resulting in more than $450,000 in overpayments. In...Read More »
Outpatient coding and billing errors led to more than half of all automated denials by Recovery Auditors, according to the latest RACTrac survey from the American Hospital Association (AHA). Outpatient errors increased by 10% from its third quarter 2014 survey with the nationwide average...Read More »
CMS underpaid Medicare Advantage plans for the cost of treating patients with multiple chronic conditions, which the organization admitted to in November. However, a new report from healthcare consulting company, Avalere Health, shines a light on some of the specifics. Read More »
Have you pitched attending the 2016 ACDIS conference in Atlanta to your boss yet? Here’s a sample letter you can use to start the conversation. Modify it as necessary and be sure to add in a few of the specific issues from sessions which you’d like to attend by reviewing the agenda.Read More »
CMS has to explain its calculation for a negative 0.2% reduction in inpatient payment rates as a result of implementing the 2-midnight rule, according to a recent court ruling. The court also said providers should have an opportunity to comment on the calculation. Read More »
For calendar years (CYs) 2012 and 2013, Medicare overpaid Nebraska Methodist Hospital in Omaha more than $111,000 for 19 inpatient and outpatient claims, including insufficiently documented sepsis and septic syndrome.Read More »
