While physician advisors (PA) and revenue integrity staff have separate roles and responsibilities, they share many of the same goals, says Anuja Mohla, DO, FACP, MBA, ACPA-C, CHCQM-PHYADV, system medical director of utilization management at ChristianaCare in Newark, Delaware....Read More »
The Office of Inspector General (OIG) released new guidance to detail key risk areas relevant to the Medicare Advantage (MA) program and provide recommendations to various parties to mitigate these risks.Read More »
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 »
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 »
