Appeals cost providers roughly $118 per claim—extrapolated nationwide that amounts to as much as $8.6 billion in administrative costs necessary to recover initially denied claims, according to a new report from Change Healthcare,...Read More »
CMS released a change request May 30 describing changes which will be implemented in the July 2017 quarterly update to the outpatient prospective payment system (OPPS...Read More »
Take a close look at the documentation guidelines that CMS suggests for the practice improvement portion of the merit-based incentive payment system (MIPS) and you may ward off future audits and avoid forfeiting revenue, according to the...Read More »
Q:Should CDI take the criteria from the National Quality Forum (NQF), Agency for Healthcare Research and Quality (AHRQ), and the Centers for Disease Control and Prevention (CDC) into consideration when querying for CAUTI,...Read More »
CMS recently released its Program for Evaluating Payment Patterns Electronic Reports (PEPPER) with statistics from the first quarter of fiscal year 2017 for short-term acute care hospitals nationwide.Read More »
CMS may have paid $729 million in electronic health record (EHR) incentive payments that didn’t comply with the federal standards between May 2011 and June 2014, according to the Office of Inspector General (OIG),...Read More »
CMS changed its selection process for medical records for short-stay reviews under the 2-midnight rule. This could be problematic for some organizations, says Ronald Hirsch, MD, FACP, CHCQM, vice president at R1 Physician Advisory Services in Chicago, according to...Read More »
“Ever since CMS announced its goal of transitioning payments to alternative and value based care models, hospitals and healthcare systems have been implementing new processes and technology to support the shift from fee-for-service to value based reimbursement. Most are already participating,”...Read More »
