A federal appeals court on December 29 rejected the hospital industry’s attempt to block CMS’ price transparency rule, effective January 1, that requires hospitals to disclose standard charges, including payer-specific negotiated rates, for 300 services.Read More »
Q: I am facing the challenge of starting a revenue integrity program at my organization. What are some of the most important steps for me to take at the beginning of this process?Read More »
This has been a year like none other. We’ve faced incredible challenges and tragedies and hospitals in particular will be navigating the lingering effects for some time. As we approach the new year, it’s time to consider what we’ve accomplished this year.Read More »
CMS announced December 18 that it will begin auditing hospitals for compliance with the Hospital Price Transparency final rule in January 2021.Read More »
The 2020 calendar year was certainly challenging for revenue integrity professionals, as the novel coronavirus (COVID-19) pandemic stressed the workforce, necessitated new working environments, and led to frequent regulatory updates. Through case studies, news, and analysis in the weekly Revenue...Read More »
The 2021 Medicare Physician Fee Schedule (final rule, released December 1, 2020, capped a turbulent year with the promise of reimbursement gains for evaluation and management and extended telehealth services, but a steep cut to the Medicare conversion factor.Read More »
The biggest surprise about the 2021 Outpatient Prospective Payment System final rule, released December 2, 2020, was how few surprises it contained. CMS finalized most policies as proposed or continued with current policies, easing some of the burden on organizations that had a scant few weeks...Read More »
Q. The IFC for MFN states on pp. 122–123, “Because Medicare allows the lesser of the applicable payment amount or the billed amount, MFN participants will have to ensure that they submit an appropriate billing amount (or charge) for the alternative add-on for the applicable quarter.” The OPPS is...Read More »
