OIG Investigates Payments for Ambulance Transports of SNF Patients
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Medicare’s Office of Inspector General (OIG) has issued a sixteen-question survey to many ambulance service suppliers. The survey is focused on SNF patients, and specifically why the ambulance service has billed Medicare Part B for transports while patients were in a Part A stay. During Part A stays, the nursing home receives Medicare payments that include funds
for...
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Understanding the Basics of Bundled Payments in Healthcare
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The shift to value-based care has driven public and private payers to redesign reimbursement models that stress accountability for care quality and healthcare costs. As the fee-for-service environment fades away, alternative payment models like bundled payments are helping to define the future of revenue cycle
management.
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Medicare Cardiac, Ortho Bundled Payments Delayed Until 2018 |
CMS pushed back the implementation of compulsory Medicare cardiac and orthopedic bundled payment models and the Cardiac Rehabilitation Incentive Payment program until 2018. CMS recently delayed the launch date of three mandatory Medicare cardiac and orthopedic bundled payment models and the Cardiac Rehabilitation Incentive Payment program from May 20, 2017, to Jan. 1,
2018.
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It is Time to be Change-Hardy with the new IPPS Proposed Rules
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Be adaptable and ready for change if you are responsible for payer reimbursements in your healthcare organization. The Centers for Medicare & Medicaid Services (CMS) has announced a large number of changes to diagnosis-related groups DRGs for 2018, along with changes in ICD-10-CM and PCS. Here is a quick summary of the
changes.
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Demystifying the Pathogenesis of Sepsis |
I want to begin with a coding scenario: sepsis and pneumonia are documented, and the coder captures these conditions and assigns MS-DRG 871 and APR-DRG 720 with severity of illness (SOI) 2. Sepsis presents challenges for coders as well as clinicians. I want to provide insight into the complex molecular and cellular processes involved in the pathogenesis of
sepsis.
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