Medicare Compliance & Reimbursement
Heads Up--OIG Is Scrutinizing Your Transfer, Discharge Billings
United Government Services (UGS) is promptly responding to an HHS Office of Inspector General (OIG) audit released last November.
The audit (A-04-04-00013) reviewed inpatient rehabilitation facilities' (IRFs') compliance with Medicare's transfer policy in 2003.
How it works: Medicare pays the full prospective payment to an IRF that discharges a patient to home, but Medicare pays a lesser amount for a transfer case, according to the OIG report. A transfer is when the beneficiary's IRF stay is shorter than average, and the beneficiary transfers to another IRF, a long-term care hospital, an acute-care inpatient hospital or a nursing home that accepts Medicare payment.
The problem: The OIG identified 585 IRFs across the country that billed "discharges to home with home health agency services," which they should bill as transfers. OIG's estimated overpayments for this case totaled $2,331,042.
In response to the OIG's recommendation for fiscal intermediaries to make proper adjustments to these claims, UGS recently posted an announcement on its Web site that it will correct the patient status code on its improperly billed claims to a transfer based on the information at the Common Working File (CWF)--and recover any overpayment.
Medicare Compliance & Reimbursement
- RADIOLOGY:
3 Tips For Coping With THe Tough New Environment
Why imaging providers could go under due to cuts.
It's a tough time to provide in-office [...] - MEDICARE:
MedPAC, CBO Gear Up To Save You From Pay Cuts
Urge Congress to listen to its advisors and scrap 10 percent cut.
If the Medicare Payment [...] - REIMBURSEMENT:
12 Tips For Securing Your Share Of 1.5 Percent Payment Boost Next Summer
Here's how to navigate the new quality measures-based system.
Starting July 1, a chunk of your [...] - PART B:
Medicare Part B Saves Big--But For Whom?
Legislative effect on quality of care is unclear.
Physicians may have benefited from Part B drug [...] - IRFs:
Heads Up--OIG Is Scrutinizing Your Transfer, Discharge Billings
UGS wastes no time correcting patient status codes.
United Government Services (UGS) is promptly responding to [...] - HEALTH IT:
Coming Soon To A Hospital Near You--A New Nationwide Health Information Network
New report on the health IT initiative details advances, future plans.
The Department of Health and Human [...] - PHYSICIANS:
Good Documentation Is The Key To Surviving An Audit
The bell curve won't shield you from modifier 25 scrutiny.
Myth: If you bill mostly 99213s [...] - INDUSTRY NOTES:
Start Sharing Those NPIs Now To Avoid A Crunch In May
Plus: Look to your Medicare FI for Unna boot coverage.
Starting in May, you could have [...]
