The Office of Inspector General (OIG) conducted an audit of Medicare Advantage (MA) organizations because some diagnoses are at a higher risk for being miscoded, which may result in overpayments from CMS. The audit is part of a larger series of audits in which we are reviewing the accuracy of...Read More »
A new CMS rule will phase out fax machines and snail mail, replacing them with electronic transactions. This phase-out seeks to prioritize healthcare provider’...Read More »
The passage of the Consolidated Appropriations Act last month will bring some changes to the Medicare provider-based billing requirements. This act funds federal departments and agencies, including the Department of...Read More »
CMS recently published a behavioral health toolkit in an effort to support state Medicaid and Children’s Health Insurance Program (CHIP) agencies ensuring children and youth get the care...Read More »
A prognostic study published in the Journal of the American Medical Association (JAMA) raises concerns that artificial intelligence (AI) models designed to predict hospital outcomes may...Read More »
Q: Why is it necessary for coders, CDI professionals, and providers to align documentation and coding for substance-related disorders when applying both the DSM-5 and ICD-10? How does this impact risk adjustment and HCC capture?Read More »
The Trump administration recently issued a presidential proclamation increasing the fee to $100,000 for new H-1B employee visas, as well as a number of other restrictions...Read More »
