A proposed rule that would expand the use of prior authorization and step therapy for Part D and Medicare Advantage beneficiaries has earned criticism from patient advocacy groups and praise from pharmacy groups.
Trouble viewing? See it online! Wednesday, December 12, 2018

News

This week in Medicare updates—12/12/2018
Source: Revenue Cycle Advisor
This week’s Medicare updates include an FAQ on the new price transparency rule for 2019, an update to the Medicare Benefit Policy Manual to include new payment policies for rural health clinics, a fact sheet on the Value-Based Purchasing Program for FY 2019, and more! 
Medicare Advantage proposed rule earns praise, criticism from pharmacy groups and patient advocacy organizations
Source: Revenue Cycle Advisor
A proposed rule that would expand the use of prior authorization and step therapy for Part D and Medicare Advantage beneficiaries has earned criticism from patient advocacy groups and praise from pharmacy groups.
 

Revenue Cycle Advisor Subscriber Content

Three steps to managing payer contracts: Educate, manage, and score
Source: Revenue Cycle Advisor
For many organizations, new payer contract terms are loaded into their contract management system and that is the end of it until the next renewal period. Operationally, these organizations are missing critical steps in ensuring that the contract is successful. Follow these three steps to ensure these contracts meet organizational goals.
 

Daily Q&A

Q&A: Social workers and RNs as case managers
Source: Revenue Cycle Advisor
Q: I am still not sure whether I need RNs or social workers or both as case managers. Is there any evidence to help me make a decision? I want everyone to be effective and work well together.

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Email your questions for consideration in the Revenue Cycle Daily Advisor. Note: We do not guarantee that all questions will be answered.
 

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Wednesday, 12/12 - CMS Web Interface Kick-Off
 

Product Spotlight

JustCoding’s Guide to Modifiers: Hospital Outpatient Edition

Healthcare professionals must stay up-to-date with guidance for reporting modifiers or they risk repeated audits and lost revenue. This book provides detailed information on the latest guidelines surrounding CPT®/HCPCS modifiers. it features comprehensive explanations of when to report each modifier, including coding tips and detailed examples.
 

    

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