Pop quiz: What’s the one scenario that allows different practitioners to complete the face-to-face encounter and the home health certification? Face-to-face encounter denials shoot down many home health claims. Make sure you’re armed with everything you need to fly high [...]
Your own stats may put reviewers on your case. If you don’t want to land on medical review, you’d better check to see whether your non-cancer length of stay figures are making you stick out like a sore thumb. In [...]
MMTA expansion also affects comorbidity groups. While some of the details have changed, the case mix steps for the Patient-Driven Groupings Model remain the same as in the proposal: Step 1: Classify episodes into four categories based on timing and [...]
The payment reform plan contains a whopping 432 case mix groups. Trying to figure out how you will fare under the newly finalized Patient-Driven Groupings Model is no easy feat. That’s in part because Medicare has added seven new clinical [...]
MAC issues NCLOS comparative billing report. Regulators and reviewers are zeroing in on hospices and their patients with non-cancer diagnoses. Find out if you stick out like a sore thumb by using new benchmarks issued by one HHH Medicare Administrative [...]
Hint: Suggested E/M documentation changes could balance shortcomings. If a hefty portion of your Part B take-home pay is tied to E/M office visits, you may want to review recent Medicare proposals. However, depending on your specialty and the number [...]
Hint: Suggested E/M documentation changes could balance shortcomings. If a big part of your Medicare pay is tied to evaluation and management (E/M) office visits, you may be concerned about recent proposals from CMS. But depending on your specialty and [...]
New PDGM is HHGM with a few tweaks. If you didn’t like Medicare’s ideas on home health payment reform last year, you’re probably not going to be happy with its newly proposed model either. Why? The Patient-Driven Groupings Model unveiled [...]
Unless CMS relents to universal industry condemnation. The preliminary pricing proposal is in, the stakeholder response rages, but unless the Clinical Laboratory Fee Schedule (CLFS) final rule makes a radical about-face, your lab could be facing the single largest payment [...]
Now you have until May 31 to get the job done. If you’re an “applicable lab” that has missed the deadline for reporting your lab-test price and volume data to CMS, you can breathe a sigh of relief. That’s because [...]
