CAH Ambulance Changes

CAH Ambulance Changes

The current policy for ambulance services furnished by a CAH or an entity that is owned and operated by a CAH is 101 percent of the reasonable costs of the CAH or the entity in furnishing those services, but only if…

Activation of OPPS System Edits Delayed

Activation of OPPS System Edits Delayed

Special Edition (SE) 19007 was revised to provide an update on Round 3 testing of system edits for Outpatient Prospective Payment System (OPPS) providers with multiple service locations and to announce a delay…

Provider Enrollment Updates

Provider Enrollment Updates

The Medicare provider and supplier enrollment process is a continuous one which requires on-going attention, lest you be impacted by an interruption in reimbursement…

ICD-10 Updates for 2020

ICD-10 Updates for 2020

CMS published the changes to the ICD-10-CM codes effective for services on or after October 1, 2019. There are 273 new codes, 21 deleted codes and 30…

Provider-Based Departments Update 2019

Provider-Based Departments Update 2019

The Centers for Medicare and Medicaid (CMS) Are Requiring Hospital Provider-Based Departments (PBDs) to be Properly Enrolled in Provider Enrollment, Chain, and Ownership System (PECOS)…

Benchmarking for Medical Practices

Benchmarking for Medical Practices

“Our life begins and ends with measurement. What was the baby’s length and weight at birth? How old was the man when he passed away? At every step in our life we are measured against something or someone…

Denial Management: Are You Doing Enough?

Denial Management: Are You Doing Enough?

“There’s tremendous pressure to reduce denials. According to CMS, 20% of all claims are denied, 60% of lost or denied claims will never be resubmitted, and 18% of claims will never be collected…

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