ROI realized from pre-bill review of documentation and coding

Published: Mon, 10/25/21

Hospitals and health systems can improve revenue through a pre-bill review prior to claims submission, according to Fee. Enjoin does this work as a revenue cycle consulting business focused on documentation and coding.

Medical Coding Slip at TX Hospital Led to COVID-19 Billing Error

Midland Memorial Hospital agreed to pay over $555,000 for a medical coding error that resulted in claims being sent out for reimbursement from the government even though patients did not have a primary COVID-19 diagnosis.

Outdated hospital billing practices present challenge to meeting new debt collection rules

Outdated billing practices, particularly in hospitals and physician offices, are causing some issues for debt collection firms as they revamp their consumer communication practices as required by law, Bloomberg Law reported Oct. 19.

CMS Finalizes One-year Extension of New Technology Add-on Payments

The Centers for Medicare & Medicaid Services (CMS) desires to use the best data available when rate setting for the upcoming fiscal year. Because COVID-19 unsettled the playing field within the healthcare arena, CMS made the decision to use data from 2019 instead of 2020 due to the COVID-19 public health emergency...

CMS Income Sharing Changes Creating Confusion

One of the provisions in the changes to the federal physician self-referral prohibition, better known as the Stark Law, announced in December 2020 imposes new limits on physician group practices. In particular, the Centers for Medicare & Medicaid Services (CMS) is...

Medicare Advantage and TPE Audits Surge

In a complaint filed last week, a New York data-mining company, DxID, was accused of allegedly helping a Medicare Advantage (MA) program game federal billing regulations in a way that enabled the plan to overcharge for patient treatment.