Revenue cycle leaders reported denials management as their most time-consuming revenue cycle task, followed by prior authorizations, according to a new survey released by AKASA. From a list of 15 different revenue cycle tasks, respondents selected...Read More »
This judicial term, the Supreme Court of the United States (SCOTUS) has agreed to hear two joint cases regarding the standard of scienter (“intent or knowledge of wrongdoing”) in legal situations pertaining to the False Claims Act (FCA).
Requiring Medicare Advantage (MA) organizations (MAO) to definitively identify payment denials on encounter records submitted for MA would enhance program oversight and help combat fraud, according to a new report submitted by the Office of Inspector General (OIG). Although most 2019 MA...Read More »
I first became aware of clinical validation denials 12 years ago. I had the great fortune of working alongside a very astute coder at the time. When the Medicare Recovery Audit Contractors began audits for clinical validation in 2011, she quickly...Read More »
FEATURES 6 Appeal writing 101 11 CDI-related denials, tracking, and tools for appeal 17 Case study: Medical necessity denials management 25 ...Read More »
