Compliance

Take a look at the file format requirements of the CY 2020 Hospital Outpatient Prospective Payment System (OPPS) Policy Changes: Hospital Price Transparency Requirements final rule.

Learn about enforcement of the requirements of CMS' CY 2020 Hospital Outpatient Prospective Payment System (OPPS) Policy Changes: Hospital Price Transparency Requirements final rule.

Learn how to establish revenue integrity best practices for Medicaid populations.

Take a look at federal Medicaid guidance and learn how to find guidance for your state's program.

The American Hospital Association (AHA) and other hospital groups argue that the final rule is unlawful because it exceeds CMS' statutory authority.

Expanded price transparency requirements are set to become reality for hospitals effective January 1, 2021. On November 15, CMS released a final rule that pushed ahead with many of the requirements originally included in the 2020 OPPS proposed rule.

Q: Our new EHR system was built using logic for therapy charging based on both the AMA and CMS eight-minute rules. Charges will generate differently based on the payer. How do others implement the eight-minute rules? How do you think using two charging methodologies in this world of price transparency will look?

Find your inspiration to stay informed and motived on your revenue integrity journey.

Valerie Rinkle, MPA, CHRI, reviews the Administrative Simplification Act and HIPAA transaction sets.

Learn about the major proposed changes, including far-reaching and complex price transparency requirements.