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Tag Archives: jessica gustafson
“Finally Friday!” New Appeals Settlement Options
Friday, November 17 2017 New Appeals Settlement Options: Low Volume Appeals & Expanded Settlement Conference Facilitation …Or… HHS’ Excuse for their Epic Failure, speaking to the Federal Judge who ordered them to reduce the OMHA Appeals Backlog: Finally Friday! … Continue reading
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Tagged cms global settlement offer, cms settlement, jessica gustafson, omha backlog
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Going the Extra Mile at Your ALJ Hearing
Retired Administrative Law Judge Bob Soltis appeared on our recent Finally Friday! show and discussed the Caring Hearts v. Burwell decision, just handed down by a Federal Appeals Court on May 31 2016. After our discussion, he wrote this blog … Continue reading
“Finally Friday!” Ambulatory Self Audits & Odd ALJ Errors in Law
FRIDAY April 24, 2015: Ambulatory Self Audits: Common Codes, Common Errors? Get the Handouts Two of the most commonly used codes on Part B claims are 99213 and 99214. This makes them rather routine… which all by itself makes them … Continue reading
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Tagged alj appeal, alj error, ambulatory audit, deepak pahuja, jessica gustafson, op audits
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“Finally Friday!” Strategies for Medicare Level 3 Appeals
FRIDAY October 17, 2014 Medicare Appeals at Level 3: Providers Left in the Lurch Veteran Appeals Attorneys Review Recent Experiences with ALJs How Can You Prepare & Respond? Watch the Replay and Get the Handouts Since CMS began re-educating the … Continue reading
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Tagged abby pendleton, administrative law judge, ALJ, appeal academy, bill malm, CMS Medicare RAC, cms rac, ernie de los santos, finally friday, health law partners, jessica gustafson, medicare appeals, RAC Audit, recovery audit contractor, sharon easterling
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“Finally Friday!” CMS Global Settlement Offer for Existing Appeals of Inpatient Claims
CMS Offers 68% for Your Appeals: How will it work and is it a good deal ? Get the Handouts Late on Friday August 29, 2014, CMS issued proposed settlement terms to acute care hospitals with pending appeals of denials … Continue reading
“Finally Friday!” Can You Get Medicare to Pay for Surgery Prep?
Is Gray the New Black? Can You Get Medicare to Pay for Surgery Prep? Watch the Replay and Get the Handouts Since there was a lot of discussion this week on the rac-relief Google Group about how to handle cases … Continue reading
“Finally Friday!” CMS OMHA Settlement Conferences and Statistical Sampling
OMHA Settlement Conferences and OMHA Statistical Sampling Alternate but Rejected Title for this Show: How CMS Plans to Use Your Money to Solve Their Problems We were joined this week by Jessica Gustafson and Abby Pendleton from The Health Law … Continue reading
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Tagged abby pendleton, appeal academy, bill malm, cms rac, craneware, ernie de los santos, extrapolation, finally friday, health law partners, ip part b rebilling, jessica gustafson, medicare appeals, OMHA, RAC, RAC Audit, recovery audit contractor, settlement facilitation, statistical sampling initiative
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“Finally Friday!” – Can You Rebill Part B for Inpatient or Not?
Joining us this week was Jessica Gustafson from The Health Law Partners, and one of our frequent listeners and commenters, Dr. Larry Field also joined us briefly – as we went over our new Decision Trees to help you know if … Continue reading
“Finally Friday!” Decision Trees for 2-Midnight Rule Conversions
Joining us this week was a panel of experts discussing our handouts, decision trees for: Day One Day Two Day Three & Beyond Conversion of OP to IP Find the PDFs below – download and post, copy, distribute, whatever – … Continue reading
Posted in Finally Friday!
Tagged 24-hour benchmark, 48-hour rule, abby pendleton, accretive pas, appeal academy, bill malm, CMS, CMS-1599, craneware, ernie de los santos, executive health resources, finally friday, jessica gustafson, recovery analytics, ron hirsch, sharon easterling, steve meyerson, tom mccarter
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“Finally Friday!” MAC Probes, AHA Lawsuits, and OIG Reports on E/M
Bill Malm of Craneware reviews some new OIG Reports, foreshadowing perhaps a flood of E/M Audits by CMS contractors. We also hear from Dr. Ron Hirsch of Accretive PAS about some of the insanity coming out of the MACs in Probe and Educate. Jessica Gustafson and Abby Pendleton from The Health Law Partners give us some legal perspective on the OIG postings, and a short review of the recent AHA filing of a mandamus complaint – a filing seeking a judicial remedy to require CMS to “meet statutory deadlines for administrative review of denials” for Medicare claims. Continue reading
Posted in Finally Friday!
Tagged 48-hour rule, abby pendleton, ama lawsuit, appeal academy, bill malm, CMS, craneware, finally friday, health law partners, jessica gustafson, mac audit, MACs, oig report, probe and educate, RAC, recovery analytics, recovery audit contractor, ron hirsch, sharon easterling
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