In Audit
Aug 21st, 2018
An OIG review shows Medicare overpaid outpatient hospitals as much as $25.8 million for complex simulations billed during audit period. Between 2013 and 2015, Medicare paid 1,193 hospitals $109,197,933 in bundled payments for intensity modulated radiation therapy (IMRT) — about $25,754,171 more than they should have, according to the Office of Inspector General (OIG). The ...
In Coding
Aug 9th, 2018
A lot rides on you knowing the difference between a preventive service and a diagnostic screening. Title I, Part A, Subpart II, Section 2713.a.1 of the Affordable Care Act (ACA), signed into law on March 23, 2010, requires commercial insurance plans to cover preventive screening services rated A or B by the U.S. Preventive Services ...
In Billing
Jul 30th, 2018
Medicare claims that do not meet date format requirements will be rejected. The Centers for Medicare & Medicaid Services (CMS) has released date formatting guidelines for the CMS-1500 claim form, which are effective for claims received on or after July 30. When date formatting requirements are not met, Medicare Administrative Contractors will return claims as “unprocessable” with t...
In CMS
May 17th, 2018
The Advancing Care Information (ACI) performance category – one of four performance categories in the Merit-based Incentive Payment System (MIPS) – is now the Promoting Interoperability (PI) performance category. What’s In a Name? For whatever reason, the Centers for Medicare & Medicaid Services (CMS) renamed the performance category. Nothing else has changed about the category. ...
Wondering what MACRA stands for? Or how to participate in MIPS? May 16 is your chance to ask questions and get answers. The Centers for Medicare & Medicaid Services (CMS) is holding a free event: Quality Payment Program: Answering Your Frequently Asked Questions Call, on May 16 from 1:30 to 3 p.m. ET. What to ...