Medicare Rule Regarding Colonoscopies

June 6, 2022

Melissa Lehrer

A Q & A to help provide clarity to the use of modifiers, E/M coding and medical necessity when coding for colonoscopies.

RARC Codes Related to the No Surprises Act

May 4, 2022

Barbara Johnson

RARCs related to the No Surprises Act, have been approved for use effective March 1, 2022.
RARCs are used to provide additional explanation for an adjustment already described by a CARC or to convey information about remittance processing.

What is Healthcare Revenue Cycle Management (RCM)?

April 6, 2022

Jon Giuliani

Learn what revenue cycle management in healthcare is, why it’s important, what can go wrong, and how to optimize revenue.

The Top 10 Revenue Cycle Issues Facing Hospitals in 2022

February 17, 2022

Jon Giuliani

Hospitals continue to face revenue cycle challenges in 2022 from ensuring compliance with updated regulations to controlling denials.

2022 Requirements for No Surprises Act: Updated

January 31, 2022

Barbara Johnson

On January 1 the No Surprises Act went into effect. Is your hospital in compliance?

CMS Releases No Surprises Act – Part II

October 22, 2021

Randi Brantner

The “No Surprises Act”, incorporated into the Consolidated Appropriations Act of 2021, becomes effective on January 1, 2022. Part 2 of the regulation was recently issued.

Appropriate Use Compliance Deadline Delayed

October 20, 2021

Barbara Johnson

The AUC program, designed to decrease the number of inappropriate advanced diagnostic imaging services, has new requirements including eight new modifiers.

5 Steps to Uncovering Lost Revenue – Taking Control of your Denials

September 22, 2021

Kevin Lee

Even before the pandemic, insurance denials were a major and costly problem in healthcare. Finding ways to reduce denials and ensure you’re paid every dollar you’re entitled to has never been more important.

CMS Raises the Stakes on Price Transparency Compliance: issues new civil monetary penalties

September 9, 2021

Randi Brantner

Due to widespread noncompliance with the Health Care Transparency Act, CMS has launched proactive audits of hospital websites. Warning letters are being sent and monetary penalties may be administered

No Surprises Act “Part 1” Regulation Issued

August 20, 2021

Randi Brantner

The “No Surprises Act”, was incorporated into the Consolidated Appropriations Act of 2021, becomes effective on January 1, 2022 with the first regulations, dubbed “Part 1”, being released on July 1, 2021 in an “Interim Final Rule with Comment Period.”

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