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Healthcare Revenue Cycle Management

POA standards from CMS website

POA Fact Sheet Interesting facts on using the POA indicator. Affected Hospitals: The Present on Admission Indicator Reporting provision applies only to IPPS hospitals. At this time, the following hospitals are EXEMPT from the POA indicator requirement: ❖❖Critical Access Hospitals (CAHs), ❖❖Long-Term Care Hospitals (LTCHs), ❖❖Maryland Waiver Hospitals, ❖❖Cancer Hospitals, ❖❖Children’s Inpatient Facilities, ❖❖Rural Health […]

CCI and OCE edits

Know what differentiates CCI and OCE edits by James Smith Send Feedback to James Smith Request Reprint | Print | About Author | Report Problem | Tweet This CCI policy manual, CCI edits, Correct C More Details about CCI policy manual, CCI edits, Correct Chere. The Correct Coding Initiative (CCI) edits for evaluation and management […]

Medicare Timely Filing Limits

https://www.noridianmedicare.com/parta/claims/timely/ppaca_timely_sub_nas_summary.pdf The Patient Protection and Affordable Care Act (PPACA), Section 6404, has reduced the maximum period for timely submission of Medicare claims to not more than 12 months beginning with dates of service on or after January 1, 2010. Medicare Timely Claim Submission Defined in PPACA  

Bill Type on UB-04

http://www.vbh-pa.com/provider/info/claimsdept/UB04_Type_of_Bill_Codes.pdf   UB-04/CMS-1450 Reference Material Type of Bill Codes (Field 4) This is a three-digit code; each digit is defined below. 1st Digit – Type of Facility   Code   Hospital     1     Skilled Nursing Facility     2     Home Health     3     Christian Science (Hospital)   […]

Healthcare IT spending to grow by triple digits: Black Book HIE survey

Health Information Exchanges (HIEs) hold boundless potential for improving the efficacy and safety of healthcare delivery by moving critical patient data to the point of care, through healthcare communities. The crucial role of HIEs to accomplish a health care organization’s move to patient-centric accountable care is undeniable, however, 97% of US physicians and 80% of […]

Sen. Franken Hearing on Accretive

On Thursday May 31, 2012  Minnesota Senator Al Franken heald a hearing into the collection practices by Accretive Health. As the author states, this should serve as a cautionary tale for all health care organizations and their third-party revenue cycle and collections vendors.

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