In the ever-evolving landscape of healthcare regulations, one crucial aspect that healthcare entities must prioritize is exclusion screening.
Busy revenue cycle teams often overlook the basic steps of charge data management to attend to more urgent priorities. These proven steps covered in this article are pivotal to keeping “charge data management” a key operational priority.
Over the last decade, one of the most exciting areas of development in healthcare has been the growth of structural heart and interventional cardiology programs—specifically, the advancement of transcatheter valvular procedure techniques. As the ability to treat a larger population using these novel techniques expands, so must our understanding of the nuances involved in navigating the current rules and regulations from both the clinical and revenue cycle perspectives.
Restructuring a hospital’s chargemaster in this era of transparent pricing often results in material increases and decreases in line item charges to align with market norms, unit costs, or a hybrid thereof. Learn how your organization can enhance its financial performance in this environment.
Wondering how the 2023 updates to E&M guidelines affect your team? Look no further. Our experts have developed a set of customized resources to aid professionals as they put the guidelines into practice.
Changes to 2023 E/M coding will impact CDM files, coding, documentation, charge capture processes, and various information systems. This article outlines new revisions to E/M codes for 2023 and addresses several questions we believe professionals will encounter when they learn of the changes.
Have you ever wondered how hospital prices became so irrational? As is often the case, things changed incrementally. Hospitals and healthcare systems have experienced years of inadequate inflationary update factors, often reduced by factors such as presumed over-coding under the federal inpatient and outpatient prospective payment systems.
CMS penalties have dramatically increased since the Price Transparency Rule was released, and providers must take heed before CMS and a legislative gauntlet arrive at their front door.
The 2022 Final Rule defines split (or shared) visits as evaluation and management (E&M) visits in the facility setting that are performed in part by both the physician and a non-physician practitioner (NPP) who are in the same group, in accordance with applicable laws and regulations.
On Jan. 1, 2017, the Centers for Medicare & Medicaid Services (CMS) and Medicare Administrative Contractors (MACs) began requiring the use of the JW modifier. The JW modifier is appended […]