Governmental audits are handled differently at every facility, but favorable results are more likely with a strong audit response that meets all ADR requirements.
“It is imperative that organizations determine who the right folks are to engage in the process,” says Diane Weiss,...Read More »
After receiving negative feedback from industry stakeholders on its new reimbursement approach for certain inpatient Medicare Advantage (MA) claims, Aetna recently extended the policy’s implementation date.Read More »
Speaking at the Revenue Integrity Symposium (RIS) is a major professional milestone in the revenue integrity field. Read our tips and suggestions to help you choose a topic and craft a strong application.Read More »
Part B reimbursement is set for significant changes starting January 1, 2026, according to the 2026 Medicare Physician Fee Schedule (MPFS) final rule, released October 31. The final rule includes numerous major changes to how CMS will calculate reimbursement, updates to telehealth services, and...Read More »
CMS directed Medicare Administrative Contractors (MAC) to lift the claims processing hold issued earlier this month for certain services impacted by the government shutdown.Read More »
Organizations have to be intentional with their AI adoption. This technology can be costly, so they must weigh out their options and locate areas of opportunity in their departments that will produce successful implementation results.
“Every organization needs to do an assessment to...Read More »
