The Top 3 Compliance and Auditing Mistakes and How to Avoid Them
In today’s environment of increasing regulatory oversight and ever-changing reimbursement policies, compliance must be more than a checkbox. Though an annual compliance and audit plan is not legally mandated, there are few healthcare organizations that don’t have compliance on their radars. However, if your compliance focus is simply to check a box, you’re missing out.
CMS Price Transparency Requirement: Six Steps Towards Ensuring Compliance and Defensible & Rational Pricing
The CMS 2019 transparency requirement underscores their ongoing initiative and emphasis on empowering patients through better access to hospital charge information.
It’s a Fact: Revenue Integrity Programs Increase Net Revenue
Is your revenue integrity program performing at full capacity? Perhaps more important, do you have a revenue integrity program (or department) at all? A survey conducted by the Healthcare Financial Management Association (HFMA) reports that less than half (44%) of providers contacted have a revenue integrity department to track accurate coding and charge capture, establish […]
Does your organization have a strategic plan to address CMS FY19 IPPS proposed rule that requires hospitals “to make public their standard charges via the Internet?”
Written By: Fred Stodolak, Executive Vice President, Mark Spehar, Senior Vice President, Financial Services, Henry Gutierrez, Vice President, Financial Services There is an increasing debate surrounding CMS FY2019 IPPS proposed rule, published April 24, that would require hospitals “to make public a list of their standard charges via the internet.” Discussions around this topic have […]
University of Utah Health: Making the Case for Auditing CDI Queries
The University of Utah has taken a unique approach to CDI. They have determined that standards and auditing are critical components of the CDI process. But how does a facility begin auditing queries? And what constitutes a compliant query?
Cultivating Homegrown Inpatient Auditors
By training coders who already are on staff, hospitals leverage institutional knowledge and build career paths. Changes in payment policies, laws, and regulatory oversight are forcing healthcare organizations to respond to increased regulatory scrutiny and audits. Medicare audits have increased by 936 percent in the past five years*. Ad hoc inpatient audits are no longer enough […]
Key Learnings from HCCA 2018 Compliance Institute Conference.
We had a great time at HCCA’s Compliance Institute conference in Las Vegas and enjoyed meeting everyone. It’s always so exciting to see all of the strategies and methods professionals across the healthcare industry are using to accomplish their diverse goals.
IR Coding: 100% Bundled, Component Coded or Hybrid-Bundled
In 1992, CPT coding options for interventional radiology (IR) procedures underwent a seismic shift in “how” to code. Gone was the old method of complete procedure codes (a one-size-fits-all code); the new method added separate options to describe “what was done” and “where or how you did it.”
The OIG Targets Herceptin Billing Errors
The OIG has added specialty drug coverage and reimbursement by Medicaid to its Work Plan.
Creating an Internal Inpatient Auditing Program
Changes in reimbursement policies, laws, and regulatory oversight are forcing healthcare organizations to respond to increased regulatory scrutiny and audits.
Pricing Transparency is Here. What Now? What next?
/in Featured /by Panacea InsightsOn August 2, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that was intended to empower patients through better access to hospital price information. Current laws already required hospitals to make public a list of their standard charges, but the new requirement which became effective on January 1, 2019, required […]