A trial court judge ruled that the Department of Health and Human Services (HHS) must eliminate the Medicare appeals backlog by 2022.
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News

Court orders HHS to clear Medicare appeals backlog by 2022
Source: ACDIS
A trial court judge ruled that the Department of Health and Human Services (HHS) must eliminate the Medicare appeals backlog by 2022. At the time of the ruling, there were more than 426,000 unresolved Medicare disputes.
CMS clarifies guidance for resolving PTP edits and MUEs, reporting modifiers -59 and -91
Source: Revenue Cycle Advisor
CMS released Transmittal 4188 on December 28, adding instructions to Chapter 23 of the Medicare Claims Processing Manual regarding the interpretation of claim edits and assignment of modifiers -59 (distinct procedural service) and -91 (repeat clinical diagnostic laboratory test) on Medicare Part B claims.
 

Revenue Cycle Advisor Subscriber Content

OCR seeks public input to improve coordinated care
Source: Revenue Cycle Advisor
In December, HHS Office for Civil Rights (OCR) released a request for information seeking input from the public to identify provisions of HIPAA that may impede value-based care or limit care coordination among individuals and covered entities.
 

Daily Q&A

Q&A: Understanding utilization review requirements for Medicare Advantage
Source: Revenue Cycle Advisor
Q: Where can I find information on utilization review requirements for Medicare Advantage?

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Upcoming CMS Events

Wednesday, 1/9 - Medicare Diabetes Prevention Program Enrollment Tutorial Webinar
Tuesday, 1/15 - ESRD Quality Incentive Program: CY 2019 ESRD PPS Final Rule Call
Tuesday, 1/22 -  Clinical Diagnostic Laboratories to Collect and Report Private Payor Rates Call
Tuesday, 2/12 -  Home Health Patient-Driven Groupings Model Call
 

Product Spotlight

Streamline Patient Financial Services Workflows for Revenue Cycle Success

Join Tanja Twist, MBA/HCM, for this 90-minute webinar with an interactive live Q&A. Twist will illustrate how to optimize patient financial services workflows and systems from the front end to the back end. Attendees will learn how to increase point-of-service collections, improve insurance verification systems, and develop successful denials management processes.
 

    

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What's New

Free Webinar Highlighting Latest Coding Clinic for ICD-10-CM/PCS

Join HCPro regulatory experts January 15 for essential CDI and coding highlights from the Q4 2018 edition of Coding Clinic.
 
 

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