Vinita Magoon, DO, JD, MBA, MPH, CMQ, presented a poster at the 2018 ACDIS Conference entitled “Using denial data to improve outpatient clinical documentation.” Read More »
No, we don’t mean the common table spice. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) summarizes facility-specific data statistics for Medicare services that may be at risk for improper payments.Read More »
Tammy Combs, RN, MSN, CDIP, CCS, CCDS, will present “How to Mitigate and Manage Denials,” on Day 2 of the ACDIS conference. Combs is the director of HIM practice excellence, CDI/nurse planner at AHIMA in Chicago, Illinois....Read More »
Rush University Medical Center in Chicago did not comply with Medicare billing requirements for 57 inpatient and outpatient claims reviewed by the OIG, according to the OIG’s November report. According to the report, this...Read More »
Q:Our facility does not have a standard appeal letter template to respond to medical necessity denials. Do you have any suggestions for how to respond? Read More »
The improper payment rate for hospital outpatient services for the 2016 CERT report period was 5.4%, at a projected cost of $3.1 billion, which accounts for 7.5% of the overall Medicare fee-for-service improper payment rate.Read More »