Tag Archives: QIO

Reminder: BFCC-QIOs have Resumed Two-Midnight Reviews

Given the resumption of BFCC-QIO short-stay reviews, providers should be prepared for BFCC-QIO review of claims that fall within the six-month look back period and were not formally denied. Continue reading

Posted in Industry News | Tagged , , , , | Leave a comment

CMS Delays JW Modifier and Tells QIOs to Re-Review Denials

A representative of CMS stated that the July 1 2016 deadline for required use of the JW Modifier to report drug wastage is being moved to January 1 2017, on an Open Door Forum Conference Call, today. A transmittal is forthcoming to confirm the change, they also stated. Continue reading

Posted in Academy Blog | Tagged , , , , , , , , | Leave a comment

CMS issues more details on pause of QIO two-midnight review

CMS has provided additional information on its temporary pause of BFCC-QIO claim audits under the two-midnight inpatient admissions policy. CMS anticipates that QIOs will resume audit activities within 60-90 days. Continue reading

Posted in Industry News | Tagged , , , , , , | Leave a comment

CMS Temporarily Pauses Two-Midnight Reviews by QIOs

Reasoning Unclear, Time-frame Indeterminate Audits of Medicare claims concerning the Two-Midnight Rule are temporarily suspended by CMS, to allow CMS to collaborate with the two BFCC-QIO contractors, Livanta and KEPRO, “to ensure consistency in how the rule is applied to … Continue reading

Posted in Academy Blog | Tagged , , , , , , , , , , | Leave a comment

KEPRO Two-Midnight Short-Stay Reviews Kick-off Webinar

Below is our recording of the KEPRO Two-Midnight Short-Stay Reviews Kick-off Webinar, recorded live on Wednesday, September 29, 2015. The PDF of the slide deck is available here.

Posted in Academy Blog | Tagged , , , , , | Leave a comment