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Displaying records 1 to 20 out of 2894 results for "medicare outpatient outliers".
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SORT RESULTS BY: RELEVANCY | PUBLICATION DATE
The Centers for Medicare & Medicaid Services (CMS) has released its final PPS Rule for 2017 a
Propublica, dissecting data released by Medicare on payments made to health professionals in 201
Inpatient hospital claims and Medicare Secondary Payer (MSP) claims with Medicare Coins
Q: We are doing some training on the 28/35 rule for Medicare. We know that (if it is medically ne
CMS revises Medicare systems to accurately process inpatient hospital claims, MSP claims
NOVEMBER 4, 2015
JUSTCODING
The use of “Observation Status” – treating certain hospitalized Medicare patien
AUGUST 21, 2014
You ask the following question: Is it legal for the outpatient therapy agency to provide services
A bill changing notification of outpatient observation status for hospital patients has be
AUGUST 14, 2015
OIG posts Medicare Compliance Review of Saint Luke's Hospital On Augus
On March 8th, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule t
MARCH 11, 2016
  “Under the Inpatient Prospective Payment system (IPPS), Medicare reimburse
If you’ve ever wondered how Medicare reimburses hospitals and pays physicians, new data fro
The 2015 Medicare Compliance Forum is the only seminar that will teach you how to respond to the
Join October 27–28 in Charleston, South Carolina, for the 2015 Medicare Compliance Forum. T
The 2015 Medicare Compliance Forum is the only seminar that will teach you how to respond to the
Join October 27–28 in Charleston, South Carolina, for the 2015 Medicare Compliance Forum. T
To ensure hospitals are up to date on important Medicare regulatory issues in light of increased
JULY 13, 2011
A new analysis by the Centers for Medicare and Medicaid Services has found only 40 medications re
JANUARY 12, 2016
For calendar years (CYs) 2012 and 2013, Medicare overpaid Nebraska Methodist Hospital in Omaha mo
This week, the Centers for Medicare & Medicaid Services (CMS) issues Transmittal 3591. It p
Nearly one in five Medicare patients fall prey to medically related injuries unrelated to their u
The 2014 Medicare Compliance Forum is the only seminar that will teach you how to respond
The top five reasons to attend the 2014 Medicare Compliance Forum The 2
On Aug. 25, CMS published Medicare Claims Processing Transmittal 3853, updating billing, payment
SEPTEMBER 4, 2017
After missing a proposed fall start date, CMS has announced last week that its Medicare Part B dr
DECEMBER 27, 2016
The 2014 Medicare Compliance Forum (October 23–24) is the only seminar that will tea
The 2014 Medicare Compliance Forum (October 23–24) is the only seminar that will tea
In the final 2018 outpatient prospective payment system (OPPS) rule released by CMS, total knee a
MARCH 15, 2019
by: Josh Poltilove Adjustments to Medicare’s home health payments und
Do you have a Medicare patient who has been on observation status in your hospital for more than
SEPTEMBER 1, 2015
  The 2014 Medicare Compliance Forum, on October 23 and 24, is the only seminar th
OCTOBER 8, 2014
JUSTCODING
When will the Medicare trust funds run out? That depends on who you talk to. According to
APRIL 27, 2018
by Josh Poltilove Adjustments to Medicare’s home health payments under the
  Part B Outpatient Therapy Q&A
  In an effort to reduce the backlog of Medicare clai
SEPTEMBER 4, 2014
On July 8, 2015, the Centers for Medicare & Medicaid Services (CMS) update included pr
Medicare Compliance Review of Saint Luke's Hospital of Chesterfield for 2011 and 2012
Medicare Compliance Review of Saint Luke's Hospital of Chesterfield for 2011 and 2012
The Medicare Boot Camp—Provider-Based Departments Version provides educati
The Medicare Boot Camp—Provider-Based Departments Version provides educati
Q: We have a physician who is sending patients to our outpatient clinic to receive
July 2015 quarterly Average Sales Price (ASP) Medicare Part B drug pricing files and revi
The Centers for Medicare & Medicaid Services should openly urge Congress to change the way th
SEPTEMBER 11, 2014
The Centers for Medicare & Medicaid Services (CMS) has released new "G" codes that
The medicare/medicare-fee-for-service-payment/physicianfeedbackprogr
CMS releases July 2015 quarterly Medicare Part B drug pricing files and revisions&n
  CMS recently updated the Medicare Claims Processing Manual, with changes
SEPTEMBER 17, 2014
JUSTCODING
President's FY 2016 Budget Includes Medicare Provisions On F
  Top problems SNFs encounter when billing for Part B outpatient therapy units
DECEMBER 4, 2015
  October CY 2015 quarterly update to the Medicare physician fee schedule datab
There will be no issue of JustCoding News: Outpatient published the week of October 15. The next
OCTOBER 1, 2014
JUSTCODING
Join us October 26 in Charleston, South Carolina, at the 2015 Medicare Compliance Forum Revenue I
July 2015 quarterly Average Sales Price (ASP) Medicare Part B drug pricing files and re
Quarterly ASP Medicare Part B drug pricing files released On April 25,
Q: An auditor recently reviewed our outpatient ED claims and told us that we canno
By Debbie Mackaman, RHIA, CHCO   Hospital outpatient t
JUNE 11, 2014
JUSTCODING
CMS updates Medicare Claims Processing Manual to provide language-only changes f
Clarification to Pub. 100-02, Medicare Benefit Policy Manual Regarding Antigens
APRIL 2, 2014
JUSTCODING
In December 2014, CMS posted a document on its Advisory Panel on Hospital Outpatient Payme
Outpatient procedures will still be coded using CPT®/HCPCS—the HIPAA-
In the Medicare/Coding/OutpatientCodeEdit/Downloads/FinalSumof
A change CMS made Medicare/Coding/OutpatientCodeEdit/OCEQtrRel
Each year CMS revises its Medicare-Learning-N
JANUARY 30, 2018
  Introducing Medicare Compliance Watch and Medicare Insider Daily!
SEPTEMBER 22, 2015
  Traditional Medicare vs. Medicare Advantage Q&A
FEBRUARY 24, 2017
The 2014 Medicare Compliance Forum (October 23–24) is the only seminar that will tea
Clarifications made to the Medicare Benefit Policy Manual and Medicare Progra
JustCoding News: Outpatient will not publish next week. JustCoding News: Inpatient will publish a
MARCH 25, 2015
JUSTCODING
An outpatient clinical documentation improvement (CDI) program should be aligned with a fa
Modifying the Daily Common Working File (CWF) to Medicare Beneficiary Database (MBD) Fi
  The week in Medicare updates
  This week in Medicare updates
SEPTEMBER 22, 2015
  The week in Medicare updates
Clarification to Medicare Benefit Policy Manual regarding antigens and deletion of Sect
CMS releases July 2014 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files
October 2014 update of the hospital outpatient prospective payment System (OPPS)
October 2014 update of the hospital outpatient prospective payment System (OPPS) On
In 2012, CMS established the Hospital Outpatient Payment Panel as an independent review en
Q: Our physicians have started performing endomyocardial biopsies on an outpatient
Q: We perform electrophysiology (EP) studies in our catheterization lab for outpatients
  CMS invites Medicare Part A providers to learn new Medicare Cost Report e-filing system
OCTOBER 5, 2018
  Medicare Review: Ways to evaluate claims
OCTOBER 2, 2015
  Product Spotlight: Medicare Compliance Watch
SEPTEMBER 22, 2015
  Medicare's open enrollment period
NOVEMBER 18, 2016
  Avoiding Medicare fraudulent billing
JANUARY 27, 2017
  Medicare Managed Care Appeals & Grievances
  New Medicare cards are out
SEPTEMBER 22, 2017
  New Medicare Card Rollout
  Medicare to pay more for DME services
  Documentation terminology that will not support the Medicare claim
  New Medicare card mailing update
  Medicare is the secondary payer: Now what?
  New Medicare card update
SEPTEMBER 21, 2018
April 2014 update of the hospital outpatient prospective payment system (OPPS)
When a patient joins a Medicare Advantage (MA) plan, he or she takes on a subscriber number, but
Those who are interested in using ICD-10-PCS for outpatient hospital coding may question w
Outpatient coding and billing errors led to more than half of all automated denials by Recovery
Modifying the Daily Common Working File (CWF) to Medicare Beneficiary Database (MBD) Fi
The Advisory Panel on Hospital Outpatient Payment (HOP Panel) summer meeting
CMS releases the Medicare fee-for-service 2013 improper payments report
FEBRUARY 1, 2015
http://www.medicarecompliancewatch.com/news-analysis/week-medicare-updates-9302015 
“As hospitals employ more and more outpatient practitioners, adequate vetting of competenc
MARCH 24, 2016
Semi-Annual Meeting of the Advisory Panel on Hospital Outpatient Payment (HOP Panel)
On August 25, 2015, The Centers for Medicare & Medicaid Services issued 2014 quality a
AUGUST 28, 2015
  Note from the Instructor: Overview of the four parts of Medicare, Part I
SEPTEMBER 22, 2015
  Medicare Compliance Forum-Take advantage of throwback pricing!
SEPTEMBER 29, 2015
  Ending Medicare Part A Skilled Services
NOVEMBER 20, 2015
  How does a payment ban impact Medicare SNF coverage?
JANUARY 15, 2016
  More oversight is required to prevent fraud and abuse of Medicare
  Fine-tune the fundamentals: Medicare eligibility for SNF services
MARCH 24, 2016
  Medicare Part A admissions: Best practices for your facility
APRIL 22, 2016
  Proposed fiscal year 2017 payment and policy changes for Medicare announced
APRIL 22, 2016
  Medicare billing: A common compliance risk area
APRIL 15, 2016
  GAO finds Medicare appeals backlog not decreasing fast enough
  Medicare makes enhancements to the Shared Savings Program
  Centers for Medicare & Medicaid Services Special Open Door Forum
SEPTEMBER 2, 2016
  Medicare Advantage premiums remain stable in 2017
SEPTEMBER 23, 2016
  Medicare Advantage Value-Based Insurance Design Model refined
OCTOBER 7, 2016
  CMS Finalizes the New Medicare Quality Payment Program
OCTOBER 28, 2016
  CMS is updating the Medicare drug spending dashboard
DECEMBER 29, 2016
  Navigating Medicare Advantage: MAOs and Protecting Reimbursement in Long-Term Care
FEBRUARY 24, 2017
  New Medicare Compliance and Ethics Program Requirements
  Avoid common errors that lead to Medicare denials
  How to make the most of your Medicare Review
AUGUST 8, 2017
  New Medicare Card Project Special Open Door Forum
JANUARY 19, 2018
  CMS proposes Medicare Advantage and Part D payment and policy updates
FEBRUARY 2, 2018
  Updated 2018 Medicare Part B physician fee schedule in effect
MARCH 16, 2018
  Five essential resources for navigating the Medicare appeals process
MARCH 16, 2018
  Billers instructed to review CMS updates to Medicare policy manuals
MARCH 23, 2018
  Look out for new Medicare cards in the mail
  CMS raises Medicare Advantage pay rates by 3.4% for 2019
  Scrutinizing Medicare coverage for physical, occupational and speech therapy
APRIL 13, 2018
  Q&A: Post-Medicare audit processes
  Should traditional Medicare cover chronic care?
  Medicare's prior authorization program may continue under GAO recommendation
  New Medicare cards: What's that square code?
  CMS seeks public comment on new proposed Medicare application process
  Claims for Medicare Diabetes Prevention Program services being denied
  Flowcharts to help you with the Medicare appeals process
  Medicare physician fee schedule: What's changing for 2019?
  CMS to present an overview of the Medicare Secondary Payer Recovery Portal
AUGUST 3, 2018
  Key documentation criteria for supporting the Medicare claim
SEPTEMBER 21, 2018
  CMS releases 2019 Medicare Parts A&B premiums and deductibles
OCTOBER 19, 2018
  Your Medicare Advantage plan may be inappropriately denying payments
OCTOBER 5, 2018
  Frequently asked questions about Medicare Part B
NOVEMBER 30, 2018
We have exciting news for our Medicare Insider customers. Starting next week, we’ll be offe
SEPTEMBER 15, 2015
Does your facility perform outpatient clinical documentation improvement (CDI) reviews?
SEPTEMBER 3, 2014
JUSTCODING
Does your facility perform outpatient clinical documentation improvement (CDI) reviews?
SEPTEMBER 10, 2014
JUSTCODING
SEPTEMBER 24, 2014
JUSTCODING
Is your organization planning to code outpatient procedures using ICD-10-PCS as well as CPT®
MAY 6, 2015
JUSTCODING
Does your hospital have an inpatient or outpatient clinical documentation improvement (CDI) progr
DECEMBER 2, 2015
JUSTCODING
By Steven Andrews Outpatient coding and billing errors lead to more than half of all au
MLN Matters released the January 2015 edition of the Medicare Quarterly Provider Complia
medicare-updates-%E2%80%93-100
As Medicare and Medicaid celebrate their 50th anniversary protecting the health and well-b
AUGUST 7, 2015
The Medicare/Coding/OutpatientCodeEdit/OCEQtrReleaseSpecs.html
FEBRUARY 18, 2015
JUSTCODING
The 2015 Medicare Compliance Forum pairs leading Medicare experts with practicing provider
The government shutdown began at midnight Jan. 20. But HHS’ website indicates the Medicare
 Citing “stakeholder concerns,” the Centers for Medicare & Medicaid Services
JUNE 19, 2018
SEPTEMBER 3, 2014
JUSTCODING
Hospital outpatient therapeutic services, such as ED or clinic visits, that are paid under
APRIL 2, 2014
JUSTCODING
MARCH 19, 2014
JUSTCODING
APRIL 30, 2014
JUSTCODING
MAY 14, 2014
JUSTCODING
JULY 9, 2014
JUSTCODING
Q:  Should a blood tranfusion received at an outpatient clinic be coded on the
AUGUST 20, 2014
JUSTCODING
OCTOBER 1, 2014
JUSTCODING
MAY 27, 2015
JUSTCODING
With the rise of healthcare services outside traditional hospital settings, outpatient practitio
FEBRUARY 4, 2016
  Bolster billing compliance: Implement a Medicare Part A triple-check process
The 2015 Medicare Compliance Forum features a robust line-up of topics and speakers to address th
  The Medicare Meeting: How to ensure proper communication during a resident's Part A stay
NOVEMBER 13, 2015
  Medicare Makes Enhancements to the Shared Savings Program to Strengthen Incentives for Qualit
  Care Plans and Medicare Payments: Why care plans must move toward functionality
  CMS examines inappropriate guiding of people eligible for Medicare or Medicaid into Marketpla
AUGUST 19, 2016
  Dementia Care Added to Medicare Advantage Value-Based Insurance Design Model
DECEMBER 22, 2016
  Bill introduced to add dental, hearing, and vision services under Medicare coverage
FEBRUARY 1, 2017
  Obstructing audits could lead to Medicare exclusion for long-term care facilities
MARCH 17, 2017
  Medicare fraud and improper payments remain black stain under President Trump's microscope
APRIL 14, 2017
  Improvements to the Medicare Claims Appeal Process and Statistical Sampling MLN Connects Call
  New Medicare cards offer greater protection to more than 57 million Americans
  CMS using MEDCAC’s recommendations for health outcomes in the Medicare population
  Medicare proposes changes to payment rates and quality programs for SNFs in FY18
  Accounting for Medicare A coinsurance from Medicaid or Managed Medicaid bad debt
AUGUST 2, 2017
  SNF ABNs: Avoiding common errors that lead to Medicare Part A denials
AUGUST 16, 2017
  MedPAC comments on CMS’s proposed rule on Medicare Part C and Part D
JANUARY 5, 2018
  New Medicare card project special open door forum March 20
MARCH 16, 2018
  CMS says this is number one reason for Medicare denials, publishes provider tips
MARCH 23, 2018
  CMS call to clarify qualified Medicare beneficiary (QMB) program billing requirements
  Update to Medicare Claims Processing Manual, Chapter 23, Section 60.3
SEPTEMBER 21, 2018
  Combing patient records for additional diagnosis codes reaps massive returns for Medicare Adv
SEPTEMBER 7, 2018
The American Hospital Association calls CMS’ proposed 2% reduction in outpatient payments &
Q: Does an unstageable on spine qualify someone under Medicare A for a SNF?
SEPTEMBER 19, 2014
Check out the new dates for HCPro’s Medicare Boot Camps, and choose the one that's b
Check out the new dates for a Medicare Boot Camp. Choose the one that's best for you.
A new Department of Health and Human Services report shows that Medicare spending for each indivi
 This week’s updates include a new ACO dialysis model, new Medicare utilization and pa
On September 1, CMS published MLN Matters 9815 to supplement CMS Medicare Financial Management Tr
SEPTEMBER 18, 2017
This week’s updates include the beginning of Medicare Open Enrollment; January 2016 qua
CMS doesn't require Medicare Advantage plans to have a face-to-face document for home health. Bu
Citing “stakeholder concerns,” the Centers for Medicare & Medicaid Services (CMS)
SEPTEMBER 1, 2018
When outpatient hospitals and physicians switch to ICD-10-CM diagnosis codes October 1, 20
The Centers for Medicare & Medicaid Services (CMS) today issued final regulations for the Med
The Centers for Medicare & Medicaid Services (CMS) released final Medicare Advantage (MA) and
APRIL 17, 2015
Q: If a stroke patient uses 100 Medicare days in a skilled nur
FEBRUARY 13, 2015
On July 28, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a notice updatin
On August 18, 2016, The Centers for Medicare & Medicaid Services (CMS) issued a request for
AUGUST 19, 2016
Medicare Boot Camp—Rural Health Clinic Version is a one-day intensive course on Medicare co
Medicare Boot Camp—Rural Health Clinic Version is a one-day intensive course on Medicare co
Long-term care providers will be able to appeal certain Medicare claims decisions without
The 2015 Medicare Compliance Forum features a robust line-up of topics and speakers to address th
On September 21, 2015, the Centers for Medicare & Medicaid Services (CMS) announced
SEPTEMBER 25, 2015
Physician practices are under increasing financial pressure, and Medicare accounts for a large po
Physician practices are under increasing financial pressure, and Medicare accounts for a large po
On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule
APRIL 22, 2016
On June 6, 2016 the Centers for Medicare & Medicaid Services (CMS) released a final rule imp
Medicare Boot Camp®—Rural Health Clinic Version is a one-day intensive course on Medica
Physician practices are under increasing financial pressure, and Medicare accounts for a large po
DECEMBER 27, 2016
Physician practices are under increasing financial pressure, and Medicare accounts for a large po
DECEMBER 13, 2016
Physician practices are under increasing financial pressure, and Medicare accounts for a large po
Physician practices are under increasing financial pressure, and Medicare accounts for a large po
The Medicare Access and CHIP Reauthorization Act of 2015 requires CMS to remove social security n
Medicare regulations are constantly evolving. Get updates on all areas of the Medicare process an
SEPTEMBER 4, 2014
CMS has reversed its stance requiring Medicare Advantage (MA) plans to apply Medicare fee-for-ser
  When outpatient hospitals and physicians switch to ICD-10-CM diagnosis codes Oct
MAY 14, 2014
JUSTCODING
Medicare recently announced the creation of a new accountable care payment model, which asks prov
  In a report produced jointly by the Medicare Payment Advisory Commission and the
JANUARY 30, 2015
  Change is right around the corner, so attend the 2015 Medicare Compliance Forum
Q: When does Medicare consider a wound as chronic/nonhealing and no longer
The 2015 Medicare Compliance Forum features a robust line-up of topics and speakers to address th
An estimated 30% of Medicare payments are now tied to alternative payment models that reward the
On Wednesday, October 12, 2016, CMS posted Transmittal 273, regarding Medicare Regulatio
JUNE 11, 2014
JUSTCODING
JUNE 25, 2014
JUSTCODING
MAY 28, 2014
JUSTCODING
SEPTEMBER 3, 2014
JUSTCODING
JULY 23, 2014
JUSTCODING
APRIL 15, 2015
JUSTCODING
MARCH 18, 2015
JUSTCODING
FEBRUARY 18, 2015
JUSTCODING
FEBRUARY 4, 2015
JUSTCODING
MAY 27, 2015
JUSTCODING
JUNE 24, 2015
JUSTCODING
AM0150 would be answered “2”—Medicare (HMO/managed care/Advantage plan).
On June 15, the Medicare Payment Advisory Commission (MedPAC) releases its June 2016 Report to t
Q:    If a beneficiary changes from one Medicare Advantage plan to another,
APRIL 25, 2014
Overview On May 1, 2014, the Centers for Medicare & Medicaid Serv
On April 28, 2015, The Senate Finance Committee held a hearing about the Medicare appeal p
The Centers for Medicare and Medicaid (CMS) has fined 12 Medicare Advantage plans nearly $4 milli
APRIL 21, 2015
Medicare doesn’t differentiate between skilled and unskilled personal care because there is
CMS pushed back the deadline for physicians to enroll to prescribe Medicare Part D drugs. Physici
We are seeking a Medicare Regulatory Specialist for HCPro-BLR Healthcare to teach our Medicare B
We are a Medicare/Medicaid certified agency. We currently have a client who is homebound
The Centers for Medicare & Medicaid Services (CMS) announced a six-month extension of a state
Physician practices are under increasing financial pressure, and Medicare accounts for a large po
In February a federal judge accepted Medicare’s plans to better educate the public about in
On the heels of the 49th anniversary of the signing of Medicare and Medicaid into
MAY 28, 2014
JUSTCODING
MAY 21, 2014
JUSTCODING
JUNE 4, 2014
JUSTCODING
JUNE 11, 2014
JUSTCODING
Q: Do any general guidelines exist for queries on outpatient services? We are beginning
OCTOBER 29, 2014
JUSTCODING
Hospitals are experiencing more outpatients in their units. Even for inpatients, hospitals freque
NOVEMBER 5, 2014
JUSTCODING
Drug administration is one of the most common services provided in the outpatient setting,
JUNE 10, 2015
JUSTCODING
Medicare regulations are constantly evolving. Get updates on all areas of the Medicare pro
APRIL 24, 2015
Medicare regulations are constantly evolving. Get updates on all areas of the Medicare pro
APRIL 17, 2015
  Medicare regulations are constantly evolving. Get updates on all areas of the Me
MARCH 27, 2015
  Medicare regulations are constantly evolving. Get updates on all areas of the Me
MARCH 20, 2015
  Medicare regulations are constantly evolving. Get updates on all areas of the Me
MARCH 13, 2015
  Medicare regulations are constantly evolving. Get updates on all areas of the Me
Medicare regulations are constantly evolving. Get updates on all areas of the Medicare pro
Medicare Trustees Report shows continued slow cost growth On July 22, C
Medicare Trustees Report shows continued slow cost growth On July 22, CM
Trustees’ report shows Medicare solvent to 2030  
Outpatient antibiotic overuse peaks and valleys throughout the year This March, a team
AUGUST 1, 2018
Physician practices are under increasing financial pressure, and Medicare accounts for a large po
The Centers for Medicare & Medicaid Services (CMS) has announced the 2014 Part B premiu
NOVEMBER 22, 2013
Q: If a beneficiary changes from one Medicare Advantage plan to another-do they automatica
MARCH 21, 2014
A record number of hospitals were fined by Medicare for having too many 30-day readmissions, acco
OCTOBER 7, 2014
Today, the Centers for Medicare & Medicaid Services (CMS) announced two initiatives to
OCTOBER 9, 2014
On April 23, 2015, the Centers for Medicare & Medicaid Services (CMS) issued a propose
APRIL 24, 2015
According to a recent report to Congress, OIG estimates that Medicare could have saved bil
MARCH 20, 2015
An unlicensed physician has been convicted for his role in a scheme to bill Medicare for h
FEBRUARY 12, 2015
In its first two years, Medicare’s Pioneer ACOs reported savings of $384 million, and pati
Centers for Medicare & Medicaid Services (CMS) announces through its acting administra
Earlier in July, CMS sent a letter out to Medicare providers. The letter was sent as a rem
You won’t find any mention in the Medicare coverage criteria about chronic or nonhealing wo
On September 21, CMS released a fact sheet stating Medicare Advantage and Part D will continue to
On November 3, 2015, the Centers for Medicare & Medicaid Services (CMS) released an interac
NOVEMBER 6, 2015
This week, Medicare officials announced the creation of 121 new accountable care organizations (
JANUARY 14, 2016
On August 4th, the Centers for Medicare & Medicaid Services (CMS) announced the participants
AUGUST 5, 2016
OCTOBER 8, 2014
JUSTCODING
Physician practices are under increasing financial pressure, and Medicare accounts for a l
Medicare Advantage Q&A with Diane Brown QWe have chro
FEBRUARY 1, 2015
Q: Is the Medicare episode payment expected to cover ostomy supplies for urinary ost
The value modifier (VM) is Medicare’s physician pay-for-performance program that rewards or
  Is your facility located in the New England area? Medicare Insider staff
HCPro's Medicare Boot Camp®–Long-Term Care Version cover
HCPro's Medicare Boot Camp®–Long-Term Care Version cover
Starting in October, 2,592 hospitals will receive lower payments for Medicare patients due to pen
AUGUST 6, 2015
On July 20, 2016, the Centers for Medicare & Medicaid Services (CMS) will convene a panel of
On August 9, the Centers for Medicare & Medicaid Services (CMS) released a new analysis demo
AUGUST 12, 2016
The Centers for Medicare & Medicaid Services (CMS) has issued an updated version of the Hospi
Medicare may verify that the provider claims (physician office claims) contain the appropriate bi
On September 18, CMS published revised MLN Matters 9815, which accompanies Medicare Financial Man
The Centers for Medicare & Medicaid Services (CMS) is proposing new regulations that implemen
AUGUST 20, 2014
JUSTCODING
OCTOBER 29, 2014
JUSTCODING
Medicare and Medicaid spending will grow at a slower rate than past predictions indicated,
According to a recent report to Congress, OIG estimates that Medicare could have saved bil
MARCH 13, 2015
If a patient switches from traditional Medicare to MA, the agency will receive a partial episode
Medicare-Learning-Network-MLN/MLNMattersArtic
As part of ongoing efforts to raise awareness about the upcoming change to Medicare numbers and c
Yes. All info has to start over again. from Medicare Administrative Contractor (MAC) CGS: “
You ask: How can I decrease the number of clinician missed visits? How do Medicare surveyors trea
Federal officials announced an accelerated effort to use payment reform to shift Medicare and the
Blogs from industry experts in healthcare that keep users up-to-date on the latest happenings in their fields.
On May 3, 2016, the Centers for Medicare & Medicaid Services (CMS) announced a final rule (
The Medicare Payment Advisory Commission (MedPAC) has submitted a vote that recommends an additio
The Centers for Medicare & Medicaid Services (CMS), issued the Q4 of FY2016 PEPPER report. Th
Long-term care providers who obstruct audits soon could have their Medicare and Medicaid c
One Week until Medicare Compliance Forum-Here are the Top Reasons Why You Should Attend
Many covered entities leave money on the table by neglecting to appeal denied Medicare claims. Re
Many covered entities leave money on the table by neglecting to appeal denied Medicare claims. Re
According to a medicare-coverage-database/details/nca-decision-memo.a
FEBRUARY 20, 2015
The Centers of Medicare & Medicaid Services (CMS) has released a new public data set, the Hom
CMS underpaid Medicare Advantage plans for the cost of treating patients with multiple chronic co
DECEMBER 3, 2014
JUSTCODING
Physician practices are under increasing financial pressure, and Medicare accounts for a l
With Medicare spending projected to grow to $1.4 trillion by 2027, the federal government is look
SEPTEMBER 4, 2017
Don’t leave money on the table! Master Medicare rules for reimbursement with the
Don’t leave money on the table! Master Medicare rules for reimbursement with the
Don’t leave money on the table! Master Medicare rules for reimbursement with the
Don’t leave money on the table! Master Medicare rules for reimbursement with the
  Don’t leave money on the table! Master Medicare rules for reimbursement
A review of Medicare CT scan claims from July 2011 to June 2012 found that 16% claims had
APRIL 30, 2014
JUSTCODING
Don’t leave money on the table! Master Medicare rules for reimbursement with the
Don’t leave money on the table! Master Medicare rules for reimbursement with the
Recovery Auditors found that 16% of Medicare CT scan claims from July 2011 to June 2012 ha
  Don’t leave money on the table! Master Medicare rules for reimbursement
How stable is the Medicare Advantage program? On July 24, th
OCTOBER 1, 2014
NOVEMBER 20, 2013
JUSTCODING
CMS releases July update to Medicare Physician Fee Schedule database 
Medicare officials continue to cite an “improvement standard” as a reason for
OCTOBER 31, 2014
In an effort to prevent medical identity theft, new Medicare cards will not list the Social Secur
CMS released Medicare-Learning-Network-MLN/ML
OCTOBER 14, 2015
JUSTCODING
The ABN (CMS-R-131) is a written notice that the agency must provide to a PPS Medicare-eligible b
Since 1997, venipuncture has not been a qualifying service for Medicare coverage. However, once
Months after NAHC had sued Medicare regarding the face-to-face requirement under the Affordable
On March 9th, the Centers for Medicare & Medicaid Services (CMS) released a public data set t
MARCH 18, 2016
On April 27, the Centers for Medicare & Medicaid Services (CMS) added six new quality measur
APRIL 29, 2016
CMS has updated pages of the Hospice Item Set Manual V2.00 as a result of the federal Medicare ag
SEPTEMBER 24, 2014
JUSTCODING
CMS issues correction to the April 2015 update to the Medicare Physician Fee Schedule D
The Centers for Medicare & Medicaid Services (CMS) has issued a
Medicare and commercial accountable care organization (ACO) models are not created alike.
FEBRUARY 21, 2017
Medicare Boot Camp®—Utilization Review Version  
Statistical sampling initiative The Office of Medicare Hearings and Appeals (OMHA) w
Q: I work in ambulance billing. I know that under Original Medicare, many non-emergen
MARCH 27, 2015
  On Thursday, CMS released a final rule updating the Medicare Shared Savings Prog
ave added several circumstances that identify Medicare as a secondary payer (MSP). This means Med
During the Medicare Payment Advisory Commission’s (MedPAC) public meeting on Thursday, Marc
“[Medicare for All policies would] surely jeopardize the relationship people have with the
APRIL 17, 2019
Medicare myths Editor's note: This article is excerpted f
AUGUST 1, 2015
The release earlier this month of secret Medicare Advantage audits CMS conducted on several major
NOVEMBER 12, 2014
JUSTCODING
Semi-Annual Meeting of the Advisory Panel on Hospital Outpatient Payment (HOP
This book is a comprehensive self-inspection guide for outpatient medical practices. Safety offic
JULY 15, 2015
Changes in Medicare and Medicaid reimbursements, healthcare reform, and market competition are al
OCTOBER 24, 2011
The Medicare appeals process has become a logjam The Medicar
AUGUST 1, 2014
The 21% "negative update" in Medicare reimbursement for physicians mandated by the Sust
Medicare’s Value-Based Purchasing ties reimbursement to quality measures, assessing criteri
Medicare is lowering all its payments to 758 hospitals by 1% over the course of the federal fisca
DECEMBER 14, 2015
Combining Medicare Boot Camp®—Physician Services Version and Evaluation & Managemen
Combining Medicare Boot Camp®—Physician Services Version and Evaluation & Managemen
HHS says the new payment system for Medicare clinicians provides flexible options that encourage
Medicare Boot Camp®—Utilization Review Version  
Due to popular demand, we’ve added another Medicare Boot Camp®
Due to popular demand, we’ve added another Medicare Boot Camp®—Utiliz
Due to popular demand, we’ve added another Medicare Boot Camp®—Utiliz
Medicare Boot Camp®—Utilization Review Version
Due to popular demand, we’ve added another Medicare Boot Camp®—Utiliz
Due to popular demand, we’ve added another Medicare Boot Camp®—Utiliz
Due to popular demand, we’ve added another Medicare Boot Camp®—Utiliz
Statistical sampling initiative for claims begins The Office of Medicar
Due to popular demand, we’ve added another Medicare Boot Camp®—Utiliz
Correction to April 2015 quarterly update to Medicare Physician Fee Schedule Database (MPFSD
Correction to the April CY 2015 quarterly update to the Medicare Physician Fee Schedule
OIG acting deputy inspector general testifies about Medicare mismanagement
July update to the calendar year (CY) 2014 Medicare Physician Fee Schedule Database
Third quarter 2015 notice of new interest rate for Medicare overpayments and underpayments pos
CMS announces final regulatory changes affecting Medicare Parts C and D
AUGUST 1, 2014
Statistical sampling initiative The Office of Medicare Hearings and App
ICD-10-related updates made to the Medicare Claims Processing Manual
Clinical laboratory fee schedule–Medicare travel allowance fees for collection of
CMS updates interest rate for Medicare overpayments and underpayment 
Medicare Boot Camp®—Utilization Review Version
 Earlier this month, the Medicare Payment Advisory Commission (MedPAC) released the
Recovery Auditors have identified numerous potential duplicate claims from Medicare Part B provid
OCTOBER 14, 2015
JUSTCODING
CMS posts July update to Medicare Physician Fee Schedule Database On June 6, CMS rel
Medicare Boot Camp®—Utilization Review Version
Physician evaluation and management (E/M) payments cost Medicare $32.3 billion in 2010—abou
Safety net hospitals—those with a Medicare Disproportionate Share patient percentage in the
The controversy around Medicare's Recovery Audit Contractor program continues; a judge has ruled
SEPTEMBER 4, 2014
Certain Accountable Care Organizations would be able to send Medicare beneficiaries to a s
OCTOBER 3, 2014
The CMS last week rolled out a new star rating system on medicare.gov/hospita
APRIL 21, 2015
On October 6, 2015, the Centers for Medicare & Medicaid Services (CMS) and Office of t
OCTOBER 9, 2015
On October 29, 2015, the Centers for Medicare & Medicaid Services (CMS) proposed to revise
OCTOBER 30, 2015
On November 24, the OIG posted a report stating that Medicare Part B and its beneficiaries paid $
DECEMBER 15, 2015
The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule this week that would
APRIL 21, 2016
The OASIS-C2 item stet is now available on the OMedicare/Quality-Ini
Since 2014, the Centers for Medicare & Medicaid Services has asked hospices to use the standa
The Centers for Medicare & Medicaid Services (CMS) announced Phase 2 of their initiative to &
Medicare payment rates for home health agencies should be reduced by 5% in 2017, and there should
The Centers for Medicare & Medicare Services (CMS) will begin beta testing on the standardize
Medicare patients at major teaching hospitals have better 30-day mortality rates for 15 common me
JUNE 2, 2017
The government should adjust Medicare payment policies to better support the type of
The Centers for Medicare & Medicaid Services announced during an Open Door Forum on Thursday
FEBRUARY 20, 2015
Centers for Medicare & Medicaid Services (CMS) Acting Principal Deputy Administrator P
Yes, Medicare will cover two visits if two individuals are needed to perform a covered service.
OCTOBER 21, 2015
JUSTCODING
OCTOBER 21, 2015
JUSTCODING
The Centers for Medicare & Medicaid Services (CMS) has begun a three-year pilot project to i
JANUARY 8, 2016
The Centers for Medicare & Medicaid Services (CMS) and America’s Health Insurance Plans
FEBRUARY 19, 2016
It’s the second year for Medicare/Medicare-Fee-for-Service-Pay
MARCH 15, 2016
The Centers for Medicare & Medicaid Services (CMS) released the Next Steps Toolkit to help y
APRIL 22, 2016
To help you improve your use of ICD-10 codes, the Centers for Medicare & Medicaid Services (
The Centers for Medicare & Medicaid Services (CMS) will soon launch a series of updates for
The Centers for Medicare & Medicaid Services (CMS) has released its final PPS Rule for 2017
A new study by the American Journal of Managed Care finds that Medicare Advantage (MA) beneficia
On September 1, CMS published MLN Matters 10235 to supplement CMS Medicare Claims Processing Tran
SEPTEMBER 18, 2017
The AMA announced earlier this week it won’t try to block Medicare’s release of bill
APRIL 10, 2014
Both houses of Congress now have passed a bill that ties skilled nursing facility Medicare reimbu
Among the proposed changes included in the Medicare Physician Fee Schedule (PFS) for calendar ye
CMS clarified changes to the Medicare Program Integrity Manual that alter the timeframe fo
In October, Medicare released its third round of penalties to hospitals that readmit patients wit
APRIL 7, 2015
On April 15, CMS posted a proposed rule in the Federal Register that would change the Medicare an
CMS recently released an ICD-10 quick start Medicare/Coding/ICD10/Dow
On February 1, a U.S. District Court judge in Vermont ordered the Centers for Medicare & Medi
With CMS regulations making inpatient admission orders an express condition of Medicare payment,
MARCH 3, 2017
The Centers for Medicare & Medicaid Services (CMS) posted a series of Frequently Asked Questi
On February 1, 2018, CMS proposed new Medicare Advantage and Part D payment and policy updates to
The Medicare Payment Advisory Commission (MedPAC) is once again recommending a 5% Medicare paymen
Notice of new interest rate for Medicare overpayments and underpayment
  Notice of new interest rate for Medicare overpayments and underpayment
Update to Medicare Claims Processing Manualto provide language-only changes for updatin
CMS finalized changes to multiple quality measures in the Medicare
For 2016, Medicare beneficiaries will have access to even more plans with high-star quality rat
OCTOBER 16, 2015
CMS is expanding the information available on its medicare.gov/physiciancomp
DECEMBER 15, 2015
CMS to hold call on value-based purchasing The Centers for Medicare &
CMS finalizes emergency preparedness of Medicare/Medicaid-certified facilities
Patients of the Medicare-certified agency who are under the care of a physician and receiving hom
A healthcare payment reform advocate is calling on Medicare officials to shift away from agency's