CMS is rescinding audit determinations for off-campus provider-based departments that claimed the mid-build exception under the 21st Century Cures Act,
CMS will begin reprocessing 2019 claims for some services rendered at excepted off-campus provider-based departments. The affected claims are for services represented by HCPCS code G0463 (hospital outpatient clinic visit for assessment and management of a patient) with dates of service between January 1, 2019, and December 31, 2019.
Successfully responding to payer charge audits for services billed above room and bed rate can be a challenge. The Cleveland Clinic contracting, compliance, and revenue cycle departments worked together on a project to address this focus.
Speakers and registrants shared tips and insights into revenue integrity hot topics on day one of the 2021 Revenue Integrity Symposium, held virtually August 17–18.