Updated Current Procedural Terminology Codes for 2019

The Current Procedural Terminology (CPT) code changes for 2019 are here! The American Medical Association (AMA) has announced the release of the 2019 CPT Code Set. The changes include 335 codes in the new CPT edition in an effort…

Cost Report Corner

Annually, CAHs must ensure that they meet the CMS criteria for cost-based reimbursement, submitting the appropriate data to their Medicare Administrative Contractor (MAC) in a timely fashion. This yearly exercise of submitting annualized procedure data to the MAC and attesting to the various CRNA qualification criteria may seem mundane to do every year – and that may be the case…

Medicare Provider Enrollment

The Medicare provider and supplier enrollment process is a continuous process in which the provider community must focus their attention, lest you be impacted by an interruption in reimbursement. Here are just a couple of the more popular items that providers find themselves contending with regarding their Medicare enrollments…

Year-End Audit and Cost Report Planning, Preparation and Tips

The few months after a facilities fiscal year end are always challenging. From closing the books, to preparing for the external audit process, to providing information for and completing the Medicare cost report, there is never enough time in the day to get everything done. We have all been through the experience– at the time we have all said “next year will be better” and “we will fix the bottlenecks”…

Tis the (Flu) Season

With summer quickly winding down, a topic of conversation for many is the upcoming flu season, particularly vaccinations. The high severity of the 2017-2018 season leaves healthcare institutions wondering what is in store for the 2018-2019 season. While the proper care of these patients remains the top priority, another aspect that should be analyzed annually is proper coding and billing for immunizations such as the flu shot…

Attention Kansas CAHs – Upcoming DSH Surveys

For all Kansas Critical Access Hospitals (CAH), the SFY 2019 Disproportionate Share (DSH) and Uncompensated Care (UCC) payment survey is expected to be sent by the end of May. If a CAH has not completed this survey in the past, this is an opportunity for hospitals to receive a DSH payment for…

Trends in Physician Compensation

Physician compensation is changing as hospitals rapidly acquire physician practices and reimbursement levels decline.  Hospitals are looking for new methods of compensation that tie their pay to productivity, on-call coverage and quality measures. Below are trends affecting the physician compensation today…

Risk Tolerance + Payor Contract Reviews/Audits

There are certain things in life and in the healthcare industry that we can trust: (1) the sun will rise in the east and set in the west, and (2) as a hospital or clinic, your primary source of income is the payment you receive from third party payors…


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