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Practical solutions for all aspects of healthcare revenue cycle management, including patient access, charging, coding, billing, revenue collection, and auditing. Tools, expert guidance, and education to ensure appropriate reimbursement and comply with Medicare regulations.
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Top Stories
- Accepting applications for program coordinator award
Nominate a coordinator colleague or yourself for our new award celebrating the professionalism of residency and fellowship coordinators.
- Providers report first RAC denials in Florida, South Carolina
Healthcare providers in several states received their first RAC denials. Connolly Healthcare, the Region C RAC for Florida, South Carolina, and several other states, has been behind many of them.
- Note: More on deductibles and coinsurance
CMS recently published the Part A deductible and coinsurance and Part B deductible amounts for CY 2010. For most covered inpatient stays, as well as covered outpatient services, Medicare does not pay the entire Medicare allowable for those stays or outpatient services. Beneficiaries generally are responsible for a portion of the Medicare allowable in the form of deductibles and/or coinsurance.
- HealthDataInsights posts several new RAC DME claim issues
HealthDataInsights (HDI) has added multiple new RAC issues to their CMS-approved list in late October and early November. The new issues are approved for RAC audits in Region D for DME claims.
- Could RAC mass adjustment changes mean increase in automatic audits?
Providers who believe their RAC denials will be limited to 200 every 45 days (corresponding with the medical record request limits) may be in for a surprise. Those limits apply only to complex audits, but no such limits exist for the number of automatic reviews RACs can perform.
- Nation's largest nursing home pharmacy to pay $98 million for kickback schemes
The nation’s largest nursing home pharmacy, Omnicare Inc., will pay $98 million to resolve allegations that it violated the False Claims Act and participated in several kickback schemes, according to a Department of Justice (DOJ) press release. Drug manufacturer, IVAX Pharmaceuticals, will pay $14 million to resolve allegations that it engaged in kickback schemes with Omnicare.
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Evaluation & Management Boot Camp - Professional Version
The most commonly used, and more importantly, audited services in a medical practice are reported using Evaluation and Management (E/M) codes. Have all your coders and auditors received formal training for E/M?The Evaluation & Management On–site Boot Camp - Professional Version will teach you the fundamentals and intricacies of E/M coding and how to perform effective E/M audits. The course goes beyond the basics and dives right into the many gray areas of E/M to expose conflicting information between CMS and local carriers.This intensive training course is geared to both coding and auditing professionals, and will show you how to evaluate documentation relative to national and local carrier guidelines with a strong emphasis on interpreting rules accurately and to maximize E/M audits.E/M services are highly audited by outside entities—your practice may be at risk.Bring the Evaluation & Management Boot Camp - Professional Version to your organization and train your entire staff. Holding an on-site boot camp is easy, cost-effective, and can be customized to fit the specific needs of your organization. For more information call 800/780-0584 or email bootcamps@hcpro.com.Click here to download a pdf of the current brochure