In Audit
Jan 8th, 2019
Explanation of Medicare Benefits (EOB) error message 96 Non-covered charge was the No. 1 reason for claims denials in December in all of Medicare Jurisdiction H, according to the region’s Medicare Administrative Contractor (MAC). “Prior to performing or billing a service, ensure that the service is covered under Medicare,” Novitas Solutions says on their website. ...
In Audit
Jan 7th, 2019
Opportunity abounds for healthcare business professionals in an expanding market. The healthcare sector created one in seven new jobs in the United States in 2018, per preliminary data released by the Bureau of Labor Statistics (BLS). Although many of those jobs are clinical, the repercussion is a growing demand for support ranks such as coding, billing, ...
In Audit
Nov 29th, 2018
A 5-year demonstration to develop improved procedures for the identification and prosecution of potential Medicare fraud occurring in the Home Health Program will begin in Illinois no sooner than Dec. 10, pending Congressional approval. The Centers for Medicare & Medicaid Services (CMS) will conduct the Review Choice Demonstration for Home Health Services in Jurisdiction M, ...
In Audit
Nov 1st, 2018
By law, the Administrative Law Judge level of Appeals has 90 days to resolve appeals submitted to the ALJ level.  However, the Department of Health and Human Services (HHS) Office of Hearings and Appeals (OMHA) has been unable to keep up with the number of appeals submitted to them which has lead to a huge ...
In Audit
Oct 2nd, 2018
If you are a particularly observant medical coder, you’ve probably noticed that many codes identified as deleted were actually promoted to new roles. Nearly 50 codes were revamped to become parent codes of more specific codes,and it’s causing some confusion because some electronic coding systems mark them as deleted AND new. Same Codes Marked as Deleted/New Take ...