Time to give your facility’s compliance plan an annual preventive exam. The Office of Inspector General’s (OIG’s) annual work plan reveals its plans for new, revised, and ongoing reviews and audits of U.S. Department of Health and Human Services (HHS) programs and operations. This year, OIG has set its sights on 24 significant new issues, ...
Dec 13th, 2016
Account for DRG and comorbidity adjustments and ensure all active medical treatments and diagnoses are documented. Part of our responsibility as healthcare business professionals is to understand the financial realities of healthcare delivery and reimbursement. For those of us working in mental health, this means learning the “ins and outs” of the Inpatient Psychiatric Facility ...
Jul 8th, 2014
As they do every year about this time, the Centers for Medicare & Medicaid Services (CMS) issued, July 3, hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) payment system policy changes and payment rates in a proposed rule (CMS-1613-P). There are no big surprises in this proposed rule. For the most part, CMS ...
Jan 1st, 2013
By Denise Williams, RN, CPC-H CMS estimates an “overall” rate increase, but changes cost methodology. In the 2013 Outpatient Prospective Payment System (OPPS) final rule, the Centers for Medicare & Medicaid Services (CMS) bases payments on claims data submitted by hospital providers during 2011. CMS is changing the calculation based on median cost to geometric ...
Jan 1st, 2011
By Denise Williams, RN, CPC, CPC-H For the 2011 Outpatient Prospective Payment System (OPPS) Final Rule, the Centers for Medicare & Medicaid Services (CMS) based payments on claims data submitted by hospital providers during 2009. Let’s highlight some of the rule to prepare you for the changes in the year ahead. You can download the ...