Reimbursement and Payment Methodologies

Representatives from CMS and the Office of Inspector General (OIG) discussed hot topics and focus areas at HCCA's 2019 Compliance Institute in Boston, including developing interactive documentation checklists, potential changes to Stark Law this year, and methods to address the high rate of coding and documentation errors on inpatient rehabilitiation facility (IRF) claims.

The pressure is on hospitals to set pricing strategies that are competitive without risking revenue. Learn how revenue integrity professionals can help their organizations take a pricing approach that's truly strategic.

Brush up on the differences between Medicare Advantage and traditional Medicare to understand how it impacts revenue integrity.

The April 2019 OPPS quarterly update reassigned specific skin substitute products from the low-cost group to the high-cost group, and clarified billing and reporting for chimeric antigen receptor T-cell (CAR-T) therapy procedures performed in the outpatient setting.

Use these communication and analysis strategies to help control medical device costs.

CMS is seeking comments on a proposed coverage with evidence development for chimeric antigen receptor T-cell (CAR-T) therapy for relapsed or refractory cancer when prescribed by the treating oncologist.

Learn how you can make an impact on revenue integrity through advocacy.

Experts offer perspective and advice on responding to CMS’ price transparency requirements.

Check your processes to implement E/M documentation changes, code updates, and expanded laboratory reporting requirements.