Follow the correct edit to promote payment and avoid denial. By Samantha Prince, BSHCM, COC, CPC, CPMA National Correct Coding Initiative (NCCI) edits for Medicare and Medicaid are not the same. If you’re following Medicare edits for Medicaid claims, you may have claims denying inappropriately. That’s missed revenue you could capture by applying the correct ...
A study by the Center for Connected Health Policy (CCHP) finds that ambiguous state laws regulating telehealth continue to restrict the expansion of the healthcare delivery method. “Expansion of the use of telehealth to deliver care has not moved as rapidly or expansively as state policymakers may have envisioned,” the report stated. Lack of clarity in ...
In CMS
Jul 13th, 2017
The Office of Inspector General’s (OIG) combat on healthcare fraud, waste, and abuse of taxpayer’s money recovers $5 for every $1 spent on investigating, which gives them incentive to target more areas of fraud. The OIG’s latest and largest fraud takedown happened this month when opioid fraud was exposed with the help of state and federal law ...
Jun 14th, 2017
If you haven’t commented on the notice of proposed revisions to the Skilled Nursing Facility Prospective Payment System (SNF PPS) case-mix methodology, it’s not too late. The Centers for Medicare & Medicaid Services (CMS) just granted an extension to the comment period. CMS Extends Comment Period for SNF PPS Case-mix Revisions was last modified: June 16th, 2017 ...
Prepare to comply with the CMS Emergency Preparedness rule now. According to the National Oceanic and Atmospheric Administration, 2015 marked the eighth consecutive year that disaster from extreme weather cost the U.S. economy more than $10 billion. Last year, this trend continued with the massive snowstorms in the Northeast, flooding in Baton Rouge, and earthquakes, ...