Managing charges for physician fee schedules is a whole different reimbursement landscape, and revenue integrity professionals who know their way around hospital-based reimbursement will need to forge a new path.
Revenue integrity professionals often run across tough questions. On the NAHRI Forums, revenue integrity professionals can get advice from peers and experts and learn about solutions others have discovered. Here are the questions that have sparked the most conversation.
CMS released the fiscal year (FY) 2019 IPPS proposed rule on Tuesday, April 24, with an overhaul of the Meaningful Use program and significant reductions to reporting requirements for quality initiatives, along with updates to payment rates.
Q: Over the last few weeks, there have been quite a few articles in various newsletters about device credits. I’m not sure we have the best process in place to identify recalls and under-warranty replacements so I took a look. In the first account I reviewed, I found an item from a St. Jude recall. When I shared my findings with my compliance officer, the response was, “Why are you looking?” Should I not look?
Using revenue reports to create tailored metrics and then monitoring with revenue reconciliation will keep an organization on track to hit revenue goals and ensure that it’s able to plan for the correct amount of revenue.
Q: When an acute rehabilitation hospital transfers a patient at 11:45 p.m. to an acute hospital emergency department, which sends the patient back to acute rehab the next morning, who is responsible for the bill?
