Compliance

Review CMS’ proposals in the 2023 Medicare Physician Fee Schedule for changes to facility E/M coding and other coverage and reimbursement updates.

Ensure your organization is complying with CMS’ latest requirements for hospital inpatient billing and reimbursement.

CMS only collected approximately half of the $498 million in Medicare overpayments identified by the Office of Inspector General (OIG) for services between October 1, 2014, and December 31, 2016, according to an audit report published in July.

Federal price transparency regulations are forging ahead with the help of state-level reinforcements like Colorado’s HB 22-1285. The act prohibits a hospital from collecting a patient’s debt if their charges were acquired on a date when the hospital was noncompliant with the CMS price transparency requirements.

Payment cuts are in the offing for Part B providers in 2023, along with a series of other projected changes targeting E/M services, COVID-19-related billing flexibilities, and value-based care, according to the 2023 Medicare Physician Fee Schedule (MPFS) proposed rule released July 7.

The American Medical Association’s (AMA) CPT Editorial Panel recently published changes to its evaluatio and management (E/M) Services Guidelines. The update includes code revisions, additions, and deletions, which are scheduled to take effect January 1, 2023.

Focus on the people and processes that make revenue integrity work.

Anna Santoro, MBA, CCS, CCS-P, RCC, CHRI, shared three steps to a proactive revenue integrity department.

Consider how CMS’ proposed changes could affect reimbursement and revenue integrity operations.