The push for health care price transparency is nothing new and can be traced back almost 20 years. When CMS released their proposed 2019 Inpatient Prospective Payment System (IPPS) rules including “requirements for hospitals to make public, a list of their standard charges via the internet”, it further underscored CMS’ continued effort for hospitals and […]
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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 […]
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.
In today’s era of intense public scrutiny on medical costs, what’s your pricing strategy? Does it pass the test of fairness and accuracy, without sacrificing revenue objectives?
Have you ever wondered how hospital prices became so irrational? As is often the case, things changed incrementally. Hospitals and healthcare systems…