When organizations receive a charge denial from a commercial payer, they must weigh their options to determine whether challenging the decision will be worthwhile.
The first step is identifying the basis of the denial. If the organization can’t determine the payer’s reasoning by reviewing...Read More »
Gain insights into CMS’ and the Office of Inspector General’s audit targets and learn how to put this knowledge to work at your organization.Read More »
The Office of Inspector General (OIG) highlighted several congressional actions that, if taken, could lead to $17 billion in potential cost savings across HHS programs.Read More »
When first learning about modifier -25, revenue integrity professionals were likely given an example of a patient in a physician office being evaluated for a minor health issue who asks to be examined for an unrelated problem at the end of the appointment.
CMS is proposing a 2.4% increase in operating payments for acute care hospitals and weighing numerous modifications to quality and reporting programs tied to reimbursement.Read More »
