Billing and reimbursement

The American College of Physicians (ACP) recently wrote a letter to CMS Administrator Seema Verma recommending that several telehealth flexibilities remain in effect for a period after the novel coronavirus (COVID-19) public health emergency (PHE) is lifted.

Q: What services will require prior authorization from Medicare starting July 1 and how do we submit prior authorizations to Medicare?

COVID-19 Medicare billing rules continue to evolve, so it can be challenging to stay abreast of the developments. Some recent changes have given case managers and hospitals more flexibility when it comes to treating both COVID-19 and non-COVID patients, as medical practices increasingly look to resume providing elective surgeries and other procedures.

CMS updated its Medicare billing FAQs to include new questions related to National Coverage Determinations (NCD) during the novel coronavirus (COVID-19) public health emergency (PHE).

Determine the impact of new regulatory relief for hospitals regarding outpatient services and telehealth originating site services provided to patients at alternate locations, including their homes.

Unintentional billing errors can occur even in the most vigilant organization. A comprehensive audit program can help detect these issues. Learn how to develop different types of audits to find and address errors.

HIM professionals have developed innovative solutions to the COVID-19 pandemic. Figuring out what works and what doesn’t will be key over the coming months. Learn how to manage the constant change and monitor for potential problem areas.

CMS released new guidance and clarification on the use of modifier -CR (catastrophe/disaster related) and condition code DR (disaster related) on June 1.

CMS packed some potentially game-changing proposals into a pared-down fiscal year (FY) 2021 inpatient prospective payment system (IPPS) proposed rule. Understand how these proposals could have far-reaching implications for hospitals.

The National Association of Healthcare Revenue Integrity’s (NAHRI) third annual Revenue Integrity Week (June 1–5) kicked off yesterday with the release of the State of the Revenue Integrity Industry Report and daily deals and drawings.