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Tag Archives: two midnight rule
Two Midnight rule helped slash improper payments for inpatient hospital claims by 58 percent, CMS says
said the overall Medicare fee-for-service improper payment rate dropped from 12.1 percent in 2015 to 11.0 percent in 2016. Moreover, improper payments for inpatient hospital claims alone dipped by 58.3 percent, from 9.2 percent in 2014 to 3.8 percent in 2 Continue reading
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 2 midnight rule, 2 mn rule, 2mn rule, BFCC-QIO, CMS, jw modifier, odf, QIO, two midnight rule
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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 2mn rule, BFCC-QIO, CMS, kepro, livanta, QIO, two midnight rule
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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 2mn rule, BFCC-QIO, CMS, cms rac, healthcare audit, kepro, livanta, medical audit, medicare audit, QIO, two midnight rule
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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.
