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.
The CMS 2019 transparency requirement underscores their ongoing initiative and emphasis on empowering patients through better access to hospital charge information.
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 […]
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 […]
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?
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 […]
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.
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 has added specialty drug coverage and reimbursement by Medicaid to its Work Plan.
Changes in reimbursement policies, laws, and regulatory oversight are forcing healthcare organizations to respond to increased regulatory scrutiny and audits.