Case management departments across the country celebrate National Case Management Week October 9 to October 15. The Case Management Society of America developed a 25-page case management promotion guide in help...Read More »
Trying to convince physicians that good documentation has “something in it for them” is a battle that CDI specialists fight each day. But a new CMS initiative that bundles physician and hospital payment into one lump sum could represent a long-term, revolutionary solution to that age-old...Read More »
$8.9 million. That is the amount Kentucky-based Baptist Healthcare Systems, Inc., had to pay as of September 1 to settle claims of improper billing related to respiratory infections and inflammations, pulmonary edema (fluid accumulation in the lungs), respiratory failure, and septicemia (blood...Read More »
Out of 88 claims for MS-DRG 246 (percutaneous cardiovascular procedure with drug-eluting stent with MCC or 4+ vessels/stents with a length of stay less than or equal to two days) reviewed during a recent probe audit, TrailBlazer Health Enterprises, LCC, fully denied 65 of them,...Read More »
Being described as "worse" in a CMS HospitalCompare data file is a dubious distinction.
A recent HospitalCompare list identifies 292 hospitals with 30-day readmission rates that are the highest in the nation in at least one of three disease categories— acute myocardial infarction,...Read More »
To make up a gap in expected overpayment collections Recovery Audit Contractors may escalate audit activities in the coming months, according to an article by Vickie...Read More »
