Compliance

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.

Use these strategies to protect revenue and strengthen compliance with inpatient-only list requirements.

Apply these tips to reduce and prevent common denials due to medical necessity, the three-day payment window, and more.

Understand how to navigate evolving guidance on observation services and medical necessity.

Brush up on revenue integrity essentials for critical access hospitals and rural health clinics.

CMS recently released FAQs on No Surprises Act implementation topics including balance billing and notice and consent requirements.

Roughly half of hospitals did not adhere to provisions of the Hospital Price Transparency rule that require them to post five types of standard charges for all services in a machine-readable file and a separate consumer-friendly file or price estimator for at least 300 shoppable services, according to a recent JAMA study.