A healthy RIS is a critical component of a healthcare facility. Make sure that yours is working the way it should to avoid lost reimbursement and reduce the risk of compliance issues.
In the ever-evolving landscape of healthcare regulations, one crucial aspect that healthcare entities must prioritize is exclusion screening.
Compliance and auditing offer an opportunity for continuous improvement. Done right they help organizations better serve patients, mitigate risk and exposure, and improve reimbursement and revenue. But what constitutes doing it right? This article discusses the three most common mistakes.
Ask Kathy Pride, and she’ll tell you: there are two ways for healthcare providers to perform proactive auditing of their claims. There’s the old way—and there’s the better way. The […]
Compliance plans are critical to making sure your organization is mitigating risk. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recommends that you audit […]
The chaos and confusion fomented throughout the American healthcare industry by the continuing COVID-19 pandemic has been bad enough in of itself – but when coders found themselves unable to […]
Typically, we would have the Final Rule updates to the Inpatient Prospective Payment System (IPPS) for the 2021 fiscal year (FY) 60 days prior to its effective date. However, this year, […]
On August 4, the Centers for Medicare & Medicaid Services (CMS) released the Changes to Hospital Outpatient Prospective Payment System (OPPS) for the 2021 calendar year (CY). The proposed regulations […]
Beginning July 1,2020 Medicare required prior authorization for five procedure classes: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation. As a reminder, prior authorization was announced through the Calendar […]
I’m sure everyone has heard the saying, “the only constant is change.” Well, it certainly rings true these days. The Centers for Medicare & Medicaid Services (CMS) issued a second interim final […]
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