Q: Are we allowed to bill the facility evaluation and management (E/M) service if a patient was triaged then left without being seen (LWBS) by a physician/nonphysician practitioner?
2023 NAHRI Leadership Council reveals hospitals are embracing robust partnerships and solutions to automate priority areas like charge capture and edits.
Automation has emerged as a driving force in hospital revenue cycle management, equipping healthcare organizations...
Q: If a patient in the emergency department (ED) leaves without being seen (LWBS) by a physician/nonphysician practitioner, should we have facility charges?
CMS is moving ahead with most of its proposed changes, including cuts to disproportionate share hospital (DSH) payments, in the fiscal year (FY) 2024 Inpatient Prospective Payment System (IPPS) final rule.
CMS has resumed testing of the activation of systematic validation edits for outpatient providers with multiple service locations. After postponing testing during the public health emergency, the agency conducted a fifth round of tests in May and revealed it is moving forward with the full production implementation of these edits.
CMS released compliance tips for pre-entitlement billing in a recent edition of its MLN Connects® newsletter. The agency instructed providers to use these billing instructions for inpatient admissions when the patient is admitted before their Medicare Part A entitlement date and discharged after that date.
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CMS is doubling down on price transparency compliance and enforcement, according to the 2024 Outpatient Prospective Payment System (OPPS) proposed rule. The proposed rule also details major changes to price transparency requirements and behavioral health reimbursement, coverage of dental services, and more.
