Medicare Compliance & Reimbursement
Documentation Crusade Targets Teaching Hospitals
Small lapses in the medical record at teaching hospitals could translate to big budgetary woes.
The Department of Health and Human Services' probe into physician billings at teaching facilities resulted in a $1.9 million civil settlement on Oct. 25 with Temple University Physicians, a physician practice of the Temple University School of Medicine.
According to U.S. Attorney Patrick L. Meehan, auditors reviewed 100 patient files submitted to the Medicare Part B Program for inpatient services rendered between 1995 and 1996. The feds say that numerous TUP claims were improperly up-coded, represented a greater level of service than what was actually provided and/or lacked any documentary evidence or sufficient documentary evidence.
TUP denies the government's allegations and denies that it has any liability in the matter.
Lesson Learned: The feds continue to target hospitals for documentation and coding errors made in the past.
Medicare Compliance & Reimbursement
- Hospitals:
Final Outpatient Rule Increases Outlier Thresholds
Why it'll be harder than ever for hospitals to get extra reimbursement for costly cases.
Under [...] - Physicians:
Feds Taking Closer Look At Docs' Billing Companies
Here are the danger signs to look for in your contracts.
If you're paying your billing [...] - DME:
Suppliers Declare Victory On Face-To-Face Exams Dispute
$57 monthly dispensing fee for inhalation drugs finalized.
The final physician fee schedule is out, and [...] - Physicians:
Pay For Part B Drugs Cut, But Physicians Can Bill For More Services
3 simple rules for getting inpatient visits right
Medicare's final physician payment rule for 2005 makes [...] - Hospitals:
Bank On These Changes For Outpatient Services
Ring in the New Year with a little bang for your bottom line.
Some significant pay [...] - Physicians:
CMS Signs Off On 4-Percent Spending Hike For Docs
Find out what's wrapped up in the extra $2.2 billion package coming in January.
The 1.5-percent [...] - Rehab:
CMS Clarifies CORF Coverage Rules
Here are the services that CMS will never cover in a CORF.
If you're receiving denials [...] - Enforcement Watch:
Documentation Crusade Targets Teaching Hospitals
How decade-old alleged errors reaped a $1.9 million settlement for one PA practice.
Small lapses in [...] - Long-term Care:
New NPP Rule A Boon For SNFs, Too
Rule could increase revenue for SNFs and improve access to care.
Come November, Medicare will cover [...] - Coverage:
Smarter Pay On The Way For ESRD Services
Good news for physicians who treat end-stage renal disease. New adjustments to the physician fee [...] - Long-term Care:
Are SNFs Ready For Surprise Spot-Checks?
"Operation Spot Check" in Florida leads to big citations.
Your compliance efforts could pay off when [...]
