HHS ordered back to the drawing board – and told to work quickly.
A federal judge has upheld a lower court’s ruling that the U.S. Department of Health and Human Services (HHS) exceeded its statutory authority when it reduced the 2018 Medicare reimbursement rate for drugs covered by the federal ...
There are steps providers should take for holding managed care plans accountable.
Considerable effort is regularly devoted by healthcare providers to overcome coverage denials through the application of the governing rules, such as they can be leveraged. Following the rules is tough in a world ...
Adding TKA to the BPCI appears to be more involved than anticipated.
As reported by the American Hospital Association and other organizations, starting in 2020, the Centers for Medicare & Medicaid Services (CMS) will be adding outpatient total knee arthroplasty (TKA) to the list of episodes in the ...
RACmonitor Partners
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Projecting results of an audit to a larger population of providers can be a serious step.
Many of the organizations with which I engage feel this pressing need to use the results of individual provider audits to infer an overall pass/fail rate, either to everything that provider does or to the ...
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Allen Jost, PhDAlvin Gore, MD, CHCQM and Cathi Charlberg, LVN, CHCQMAmanda Gilliland, RN, BSNAndrew B. Wachler, Esq.Andrew H. Hughes, MD and Charles Locke, MD, CHCQM-PHYADVAndrew Wachler, Esq., and Sarah Hillegonds, Esq.Angela Phillips, PTBarbara Vandegrift, RN, BSN, MABecky Rodrian, CPC, CEMC, CBCS, MBSBrian T. LandryChristina Panos, RHIA, CTRChristopher Halleman, DOChristopher J. Laney, Esq.Chuck BuckDaniel Zirkman, MDDavid M. Glaser, Esq.Denise Nash, MD, CCS, CIMDheeraj Mahajan, MD, FACPDuane Abbey, PhD, CFPEdward Roche, PhD, JDElizabeth C. Dunbar, MD, MBA, FACEP, CHCQM-PHYADVEllen Fink-Samnick MSW, ACSW, LCSW, CCM, CRPErica E. Remer, MD, FACEP, CCDSErin Diesel Roumayah, Esq.Frank D. Cohen, MPA, MBBGloryanne Bryant, RHIA, RHIT, CCS, CCDSGreg FordHolly Louie, RN, CHBMEJ. Paul Spencer, CPC, COCJanelle Ali-Dinar, PhDJeffrey D. Lehrman DPM, FASPS, MAPWCAJessica Forster, Esq.Juliet B. Ugarte Hopkins, MD, CHCQM-PHYADVKathleen K. Borchard, BSN, RN-ACMKathy Seward, MD, CHCQM-PHYADVKim T. Charland, BA, RHIT, CCSKnicole C. Emanuel Esq.Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-approved ICD-10-CM/PCS trainerLaurie M. Johnson, MS, RHIA, FAHIMALori O’Hara, MA, CCC-SLPMark SpiveyMarvin D Mitchell, RN, BSN, MBAMary Beth Pace, RN, BSN, MBA, ACM, CMAC
