Remember that a CBR is an educational tool. A recent comparative billing report (CBR), compiled by RELI Group Inc., examined the payment rates of bronchodilator nebulizer medications for Medicare Part B beneficiaries. From 2021 to 2022, the analysis team looked [...]
Watch out: Bonuses may put you in an overtime danger zone. You’d better dot your i’s and cross your t’s when it comes to employee compensation, because wage and hour compliance is in the crosshairs for home care providers. Multiple [...]
Keep long-term impact of expanded Level 1 edits in mind, experts urge. Chances are you need to shore up your cost reporting practices to avoid failing newly announced Level 1 edits. So indicates the Centers for Medicare & Medicaid Services' [...]
Line 3 Employee Benefits - missing from 13.80% of reports in 2016 (385 reports) Line 4 Administrative & General - missing from 0.29% of reports (8) Line 5 Plant Operations and Maintenance - missing from 45.16% of reports (1,260) Line [...]
Nearly half of nation’s HHAs will be under PCR by January. The heavy burden of Medicare’s new preclaim review demonstration is going to slam into home health agencies in the first demo state Aug. 1, while they are still scrambling [...]
Question: Sorry to bring this up again but our hospital coders are saying we cannot use 632 in the case where the Potassium Chloride was injected by the MFM provider, and our ob-gyn was the one to remove it. How can [...]
Question: Our provider documented that he performed a D&C for an incomplete abortion. We reported CPT 00940 with diagnosis ICD-9 637.91, but the payer denied the claim and said we needed a consent form because of the abortion. When we [...]
You can call benes based on a doc's order, CMS allows You need to make sure your patients who are referred by their doctors know their doc is contacting you, or you'll run afoul of a new compliance clarification from [...]
The target once again: high-therapy claims. Tighten up your therapy claims oversight or you could lose thousands of dollars per episode.A small Chicago-based home health agency is facing that fate following an audit by the HHS Office of Inspector General. [...]
Question: While in the emergency department (ED), our gynecologist saw a 17-year-old patient who had an elective abortion elsewhere. Our gynecologist had never seen this patient before. The patient came to the ED with a fever and retained products of [...]
