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 »
Back in the day (oh, about nine years or so ago), I found myself tucked into my office late into a Thursday evening skimming the tome that was the Office of the Inspector General’s annual Work Plan release. TheWork Plan is—just as its name implies—an outline or agenda of...Read More »
Recovery auditors collectively identified and corrected more than a million claims for improper payments, resulting in $2.57 billion dollars being corrected, according to CMS’ fiscal year (FY) 2014 report on the recovery audit contractor (RAC) program.Read More »
