When it comes to providing high-quality patient care, most American hospitals simply don’t. That’s if the recent round of five-star rankings from CMS are to be believed. About 1,700 hospitals (39%) earned just three out of five stars, an “average” rating. Just as consumers need to examine...Read More »
Prime Healthcare Services hospitals in California allegedly pressured emergency department (ED) physicians to admit Medicare patients without the medical necessity for an inpatient admission, according to the...Read More »
The backlog of Medicare appeals could be cleared by 2021, according to a proposed rule released by CMS and the U.S. Department of Health & Human Services on June 28.
The fiscal year (FY) 2017 IPPS proposed rule included some significant changes to Patient Safety Indicator (PSI) 90, one of which is a new name: The Patient Safety and Adverse Events Composite. A fact sheet recently released by the measure's owner, the Agency for Healthcare Research and Quality...Read More »
Q: I am with a CDI program that is starting to explore the severity of illness/risk of mortality (SOI/ROM). I personally have been reviewing for SOI/ROM for quite a while. I usually designate the impact (MCC/CC/SOI/ROM) after the billing is done and see if what I queried for...Read More »
Recovery Auditor medical record requests and automated and complex denials all fell slightly in the first quarter of 2016, as did the average number of medical record requests per hospital, which decreased slightly since the fourth quarter of 2015, according to the latest RACTrac report...Read More »
