In Audit
Aug 16th, 2018
Improper payments stem from noncompliance. Hospitals do not always comply with Medicare requirements for reporting cochlear devices replaced without cost, according to a report issued by the Office of Inspector General (OIG). The U.S. Department of Health and Human Services branch office, charged with protecting program integrity, bases its conclusion on prior compliance reviews in which it identif...
In CMS
Aug 15th, 2018
If Congress and other stakeholders continue to drag their heels, Medicare bankruptcy is a real possibility. The Medicare Part A trust fund will be depleted by 2026 and Medicare Part B spending will grow more than 8 percent over the next five years, according to the 2018 Annual Report by Medicare’s Board of Trustees. Two things ...
In CMS
Aug 13th, 2018
According to a Department of Justice (DOJ) U.S. Attorney’s Office Southern District of New York press release, Mustak Y. Vaid is the latest physician sentenced in a big Medicaid fraud ring involving six Brooklyn clinics between 2007 and 2013, who filled “prescriptions and referrals for medically unnecessary and/or non-existent tests and supplies.” He falsely posed ...
In Coding
Aug 9th, 2018
Improve your claims payment success rate by understanding bundling and add-on code rules. Electrophysiology studies and arrhythmia ablation can be tricky to report due to the number of bundled and add-on codes. Here’s a step-by-step approach to coding these medical procedures with confidence. The Value of EP Studies Electrophysiology (EP) studies are used to both diagnose ...
In Billing
Aug 9th, 2018
With diligence and quick follow-through, you can recoup payments rightfully due to providers. Managing payer denials is key to proper reimbursement. The lack of appropriate and timely claim follow-up can cost even the most successful practice significant revenue. Although appeals take time and effort, the recoupment of lost payments makes the process profitable. Rejection and ...