Q: My team is asking me if we should combine pre-admission testing (PAT) visits with the surgery bill. I'm thinking no because some of the PAT services are not routine for the surgery. However, isn't there a rule about services that can't be billed separately prior to surgery?Read More »
In the spirit of Revenue Integrity Week, which is designed to celebrate the diligence and dedication of revenue integrity professionals, NAHRI’s State of the Revenue Integrity Industry Survey once again took a deep dive into the roles of revenue integrity professionals, the activities they are...Read More »
More hospitals are cash strapped than any time since the 2008 financial crisis, according to a 2017 Moody’s Investors Service survey. Not-for-profit and public hospitals, in particular, are feeling the squeeze with median operating cash-flow margins at a 10-year low. High labor costs and lower...Read More »
U.S. District Judge Rudolph Contreras last week reaffirmed that the U.S. Department of Health and Human Services (HHS) exceeded its authority when it made 2018 payment cuts to outpatient hospitals for certain drugs purchased through the 340B drug pricing program, and extended the ruling to 2019...Read More »
Q: I was on a conference call with the CDM coordinators within my health system and we got involved in a lively discussion. If there's no medical necessity for observation, what do you do with charges? Our departments get productivity based on the charges posted. We all agreed that the...Read More »
CMS published the FY 2020 Inpatient Prospective Payment System (IPPS) proposed rule on April 23, introducing policies designed to significantly alter rural health payments and expedite opportunities to pay for new technology.Read More »