When asked to rank their level of engagement on a scale of one to 10, with 10 being the most engaged, 63.5% of physicians indicated they feel more engaged (ranking their engagement at a six or higher) with their facility than just three years ago, according to a...Read More »
Of all the Recovery Auditor denials, hospitals reported appealing about 50% with more than a 50% success rate—it’s 50/50 game that hospitals cannot afford to not play, according to the American Hospital Association’s recent RACTrac...Read More »
In the first half of the 2014 fiscal year, the Office of the Inspector General (OIG) reported more than $3 billion in audit recoveries, nearly $3 billion recovered from investigations, and nearly a million in other non-Department of Health and Human Services (HHS) investigations due to efforts...Read More »
At the close of fiscal year 2013, nearly 5,000 claims denials remained pending review at the Department Appeals Board (DAB) – the last level of administrative review following Administrative Law Judges (ALJ) appeal. The ALJs appeals backlog stood at 460,000, according to the American...Read More »
Physician evaluation and management (E/M) payments cost Medicare $32.3 billion in 2010—about 30% of all Part B payments that year—and of that amount, about $6.7 billion were incorrectly coded or documented, according to an Office of...Read More »