More payers and providers are using the independent dispute resolution (IDR) process than the government anticipated to settle payment for items and services covered by the No Surprises Act.Read More »
The Office of Inspector General (OIG) recently released its annual report on solutions to reduce fraud, waste, and abuse in HHS programs. In the OIG’s 2022 report, 16 of the top 25 unimplemented recommendations involve CMS, with three relating to Medicare Parts A and B.Read More »
It’s helpful to understand payer-specific contract terms and government billing requirements when developing work lists or work queues and reports. Analyzing data that comes from claim scrubber edits, return to provider edits, variances, and denials can provide insight into repetitive issues...Read More »
The Office of Inspector General (OIG) recently announced it will audit CMS’ monitoring and enforcement of the Hospital Price Transparency final rule. The report is expected for release in 2023.Read More »
The Office of Inspector General (OIG) recently released an audit report on Medicare integrity risks related to billing for telehealth services during the first year of the COVID-19 pandemic. Although the OIG identified only a small portion of high-risk providers, it acknowledged the need for...Read More »
