CMS provided clarification on submitting inpatient claims for patients diagnosed with novel coronavirus (COVID-19) without a positive viral test, in an update to MLN Matters SE20015 released September 11.Read More »
UnitedHealthcare’s (UHC) plan to require in-network, freestanding and outpatient laboratory claims to contain a unique code for most lab testing services is poorly timed and poses significant implementation hurdles, the American Hospital Association (AHA) said in an August 14 letter.Read More »
Q: Is there a national standard for what documentation must be submitted to Medicare Administrative Contractors (MAC) when requesting prior authorization?Read More »
Inpatient novel coronavirus (COVID-19) claims will require a positive viral test result to be eligible for the 20% increase in the MS-DRG weighting factor, effective for admissions on or after September 1.Read More »
High-level continued learning and engaged networking with peers are critical to revenue integrity professionals as healthcare regulations transform each year. We are excited to announce we will host Revenue Integrity and...Read More »
CMS’ latest round of updates to its novel coronavirus FAQs on Medicare fee-for-service billing provides additional information on hospital billing for remote services, including a decision tree guiding hospitals through their options for billing for telemedicine.Read More »
An appeals court ruled that CMS has the authority to implement a controversial site-neutral payment policy. The ruling, delivered July 17, reversed a 2019 district court decision that vacated the policy.Read More »
The Duke University Health System in Durham, North Carolina, has more than 1,200 inpatient beds, handles two million outpatient visits annually, and serves as one of the country’s leading research institutions. As the director of revenue and documentation integrity at Duke Health, Garland Goins...Read More »