Improper hospital claims dropped from $10.45 billion to $4.42 billion from the 2014 report period (July 1, 2012 to June 30, 2013) to the 2016 report period (July 1, 2014 to June 30, 2015), according...Read More »
Every year the Office of the Inspector General (OIG) publishes a list of its audit targets for the following calendar year. Although this hefty tome tops 100 pages, it’s worth a review to ensure the OIG’s targets aren’t diagnoses and documentation trouble spots at your facility.Read More »
CMS recently released details of its next round of settlements for hospitals with pending inpatient appeals to help clear a massive backlog that has been the subject of a long-running lawsuit.
With appeals waiting for adjudication before Administrative Law Judges (ALJ) ...Read More »
The pay regulations for 2017 are expected to increase Medicare payments to hospitals for outpatient services by 1.7%, according to details about the 2017 ...Read More »
When coders can rely on the written diagnosis statement from a provider, it may negate all clinical documentation improvement efforts, according to an issue brief released by the Workgroup for...Read More »
With the help of our hospital quality improvement (QI) committees, we can take action to restore the integrity of the discharge summary. Consider the following:
The American Hospital Association (AHA) released a series of videos to educate hospitals, clinicians, and trustees on the new system outlined in the Medicare Access and CHIP Reauthorization Act (MACRA).Read More »
In the largest settlement with a skilled nursing facility chain in Department of Justice history, federal prosecutors say Life Care Centers of America billed Medicare and TRICARE for unnecessary rehab therapy.Read More »
