Your hospital’s claims for telemedicine services are coming under fire, and you could soon see a significant crackdown on your compliance efforts. Get ready for the Centers for Medicare & Medicaid Services (CMS) to change the rules of the game for nabbing telehealth reimbursement. Watch More..
Ground-breaking changes to Evaluation and Management (E&M) documentation and payment are on the horizon, and the impact will vary widely depending on your specialty. Can you look forward to a pay bump—or a reimbursement reduction? Read on to find out. The scoop: CMS recently released More..
Your hospital’s Quality Assessment and Performance Improvement (QAPI) program is under more scrutiny than ever before. And with 86 percent of adverse events not reported to hospitals’ QAPI program, it’s no wonder that this is a major focus for the Centers for Medicare & Medicaid More..
Psychiatric hospitals and psychiatric units within general hospitals aren’t the only places that must comply with ligature risk-related safety regulations. Now, The Joint Commission (TJC) and the Centers for Medicare & Medicaid Services (CMS) are cracking down on all hospitals and other healthcare settings to More..
Why are modifiers 25 and 59 causing so many billing and compliance problems lately? Payers are claiming that providers are frequently misusing these modifiers, which often leads to overbilling – a big no-no. Modifiers 25 and 59 are typically high-risk, with rampant misuse, and cause More..
A cardiologist leaves her practice and joins another, after which a former patient of hers comes to the new practice for an appointment: Do you bill the visit as a new or established patient visit? Many practices are puzzled by situations like this, says Terry More..
Hospital care expenses aren’t going anywhere but up, unless you—that is, professionals responsible for hospital performance—rein them in. And the pressure to do so is certainly on. The Centers for Medicare and Medicaid Services (CMS) is grading hospitals on length-of-stay and cost-per-case data, and Medicare’s More..
Approximately 105 Americans die by suicide every day, according to the Centers for Disease Control and Prevention (CDC), with close to 6% of these deaths occurring in a hospital setting. Understandably, inpatient suicide is a growing concern for the Centers for Medicare & Medicaid Services More..
“Cross recovery” may not be a hot compliance focus area for federal and state auditors at the moment—but stricter scrutiny is on the horizon, says healthcare management consultant Duane C. Abbey. And because the cross recovery issue can rear its ugly head in a number More..
Is your hospital taking steps to protect suicidal patients from ligature risks? If not, you will now face an immediate jeopardy deficiency citation. The Conditions of Participation (CoPs) for hospitals includes numerous sections, but the section that’s earning hospitals the most deficiencies is Patient’s Rights More..