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Medically unnecessary services topped the list of claim errors in the latest comprehensive error rate testing (CERT) report compiled in November 2009 and released last month by the Centers for Medicare & Medicaid Services (http://www.cms.hhs.gov/CERT/...
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There is something about Florida in February, our sunny State just wrapped up Super Bowl XXXXIV as the Saints Came Marching In, Jamie McMurray took the checkered flag at the Valentine's Day Daytona 500, the official Strawberry Festival is imminent, thousa...
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The sky is no longer falling. It has fallen, period.
Analysis of the newly posted issues from Connolly Healthcare and HDI (Health Data Insights) reveals that for first time Rehabilitation Facilities (IRFs) and Physician Practices are now more heavily tar...
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There's a new PEPPER report, and those who know that the acronym isn't just an all-around-useful kitchen spice can now go to My Quality Net to obtain a copy.
The first 2010 release was scheduled to post on January 25 and finally made it on February 5. So...
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Connolly Healthcare, the RAC for Region C, has posted 19 new approved issues for Complex Review on their RAC Issues page.
The new issues were posted on Monday, February 8, 2010. The listed issues include only single MS-DRGs, but are still not listed in a...
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The recent announcement by CMS regarding its modification of additional documentation requests for institutional providers during fiscal year 2010 has generated considerable response from providers seeking clarification about tax identification numbers an...
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The RACs recently posted more than 560 of the current 746 MS-DRGs approved for DRG Validation, offering analysis of DRG coding, principal diagnoses, secondary diagnoses, and all diagnoses and procedure codes that could affect the DRG selection. While none...
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Inpatient rehabilitation facility (IRF) services are intended for patients requiring a resource-rich environment due to their complex nursing, medical and rehabilitation management needs.
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By: Margi Brown, RHIA, CCS, CCS –P, CPC, CCDSand Cheryl E. Servais, MPH, RHIA
In a word - YES. Our preliminary statistics indicate that more than half of RAC findings for complex reviews should be rebutted due to documentation that was overlooked or gu...
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One of the challenges currently existing within our hospitals involves sorting out all of the different priorities bidding for the attention of leadership.
During any given month, our leaders are faced with multiple competing demands, being under signifi...
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Okay, you've followed all the advice and you're prepared for the RACs, the ZPICs, the MACs, the MICs.
You've created a RAC team, drafted policies and procedures, done trial work flow processes, and sat in on who-knows-how-many webinars and conferences on...
