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News

HHS to award $70 million in grants to combat the opioid crisis
Source: Revenue Cycle Advisor
HHS recently made available $70 million in grants to help healthcare providers and communities address the opioid crisis. The grants are intended to help prevent opioid deaths and provide treatment for opioid users.
Insurers to pay record $32.5 million for claims of risk-scoring fraud
Source: HealthLeaders Media
Two large healthcare plans in Florida will pay millions to settle allegations triggered by a whistleblower's complaint that they gamed the Medicare and Medicaid systems by providing inaccurate risk scores for reimbursement.
 

Revenue Cycle Advisor Subscriber Content

Hospital brings outpatient focus to CDI
Source: Revenue Cycle Advisor
Ochsner Clinic Foundation began its ambulatory clinical documentation excellence journey in 2004, when Medicare implemented its Hierarchical Condition Categories (HCC). Since HCCs affect patients’ Risk Adjustment Factor scores, and ultimately reimbursement for the care required to treat sicker patients, Ochsner needed to determine the best way to ensure annual HCC capture for all patients across its vast system.
 

Daily Q&A

Q&A: Understanding late effects
Source: ACDIS

Q: I am having difficulty understanding “late effects.” The statement of a “condition or nature of the late effect is sequenced first,” but the code for the acute phase of an illness or injury that led to the late effect is never used with a code for the late effect, seems contradictory to me. Can you provide some additional context for me?

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

Upcoming CMS Events

Wednesday 6/7 - CMS HCPCS Public Meetings for DME and Accessories; O&P; Supplies and Other
Thursday 6/8 - CMS HCPCS Public Meetings for DME and Accessories; O&P; Supplies and Other
Thursday 6/15 - National Partnership to Improve Dementia Care and QAPI Call
Wednesday 6/28 - CLIA Certificate of Provider-performed Microscopy Webcast
 

Product Spotlight

Essential Medicare Cost Reporting Strategies

Join expert speakers Valerie A. Rinkle, MPA, and Paul Holden, FHFMA, as they review the 19 IPPS national cost-to-charge ratios for 2017 and walk through cost center mappings between IPPS and OPPS. Learn how revenue integrity and finance departments can work collaboratively to help ensure a facility’s payments are representative of its costs.
 

    

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What's New

Revenue Cycle Advisor Encyclopedia

Check out the latest terms in the RCA Encyclopedia, including value-based purchasing and key performance indicators.
 
 

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