Q: Our system has a new vendor that is helping with charge capture. We were discussing surgery level charges and a comment was made about rounding that surprised me: We don't have to follow rounding rules to select the additional 15 minutes after the first hour. The vendor acknowledged that Medicare does have rounding rules, but because the rounding rules are not listed in or specifically tied to any surgery documentation, then the rounding rules don't apply to surgery. If the total surgery time was 61 minutes, then we would have one first hour charge and one additional 15-minute charge. The vendor assured us that this was a common practice throughout all hospitals. Is this true?
It’s that time of year when Certification in Healthcare Revenue Integrity (CHRI) credential holders should start thinking about recertification requirements. The CHRI recertification process ensures that credential holders stay up to date on education and regulatory changes relevant to their field.
Q: I am facing the challenge of starting a revenue integrity program at my organization. What are some of the most important steps for me to take at the beginning of this process?
Q: I have been tasked with implementing a charge capture/revenue integrity program. I would appreciate any suggestions or tips that anyone is willing to share to assist me in beginning this process—where to start, who to include, and how to be successful with this challenge.
Q: Is there a national standard for what documentation must be submitted to Medicare Administrative Contractors (MAC) when requesting prior authorization?
Q: Can a hospital bill for a nutritionist and a dietitian deliver diabetes self-management training (DSMT) via telehealth on a UB claim? Nutritionists and dietitians are on the list of distant site practitioners, although registered nurses are not.
