News & Analysis

January 13, 2020
News & Insights

Q: What is the process for submitting a claim for an inpatient hospitalization when our utilization review committee determined after discharge that the inpatient admission was not medically necessary?

January 10, 2020
News & Insights

Q: Our coding department was told there were changes made for fiscal year (FY) 2020 when it comes to reporting healed/healing pressure ulcers and pressure-induced deep tissue damage. Can you explain any recent updates?

January 9, 2020
Medicare Insider

This week's note from the instructor reviews the prior authorization process that will be implemented for five categories of services in 2020. 

January 9, 2020
News & Insights

Q: Do you have any suggestions for training physicians on HIPAA rules and regulations?

January 8, 2020
News & Insights

The Transparency in Coverage Proposed Rule comment period has been extended from January 14 to January 29, CMS announced. The proposed rule would require insurers to provide personalized price estimates and publish negotiated in-network rates and historical payment information.

January 8, 2020
Medicare Insider

This week’s Medicare updates include transmittals on new provider specialty codes for opioid treatment programs, the implementation transmittal for the Ambulatory Surgical Center Payment System, correction notices for the 2020 Medicare Physician Fee Schedule final rule and Outpatient Prospective Payment System final rule, and more! 

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