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Tag Archives: appeal academy
Managed Care Anguish – Part 2
FRIDAY June 10, 2016: “Managed Care Anguish – Part 2“ Looking for an Rx for your Revenue Cycle? …well… Here’s some real world advice & examples Get the Handouts Sponsored by The Health Law Partners, MAS Coding Solutions THIS WEEK, … Continue reading
“Finally Friday!” The Challenge of the JW Modifier
yes, was yet another WEDNESDAY June 1, 2016: “The Challenge of the JW Modifier” A review of the requirements and challenges in implementation Or Here’s the Real Key — the Secret Sauce: Click here to See the Previous Videos Get … Continue reading
Posted in Finally Friday!
Tagged appeal academy, CMS, drug wastage, finally friday, jw modifier, sad, sad billing, self administered drugs, transmittal 3508
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“Big Data” Tools Saved Medicare $1.5 Billion
CMS implemented a Fraud Prevention System (FPS) using “big data” and predictive analytics approaches to fight fraud, waste and abuse in the Medicare fee-for-service program, five years ago. Since inception, FPS has saved Medicare over $1.5 billion in inappropriate payments … Continue reading
Self-Administered Medication – Earned Revenue or Another Write Off
Caveat emptor et provisor [Let buyer and provider beware] Written by Bill Malm, ND CMAS CRCR Many facilities struggle with the implementation and collection of earned revenues from Self-Administered Medications (SAD.) SAD has had a litany of guidance made by … Continue reading
Posted in Academy Blog
Tagged appeal academy, auditing in healthcare, audits in healthcare, clinical audits, health audit, healthcare audits, inpatient, IPPS, medical audit, medical auditors, medical audits, medicare appeal, medicare audit, Medicare Part B, Medicare Part D, opps, outpatient, sad, self-adminstered drug
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“Finally Friday!” CMS Proposes the MOON & Other Changes for the NOTICE Act
FRIDAY May 13, 2016: “CMS Proposes the MOON & Other Changes to Implement the NOTICE Act“ A Proposed Rule Inside A Proposed Rule OR How CMS can defy Congress with a straight face Get the Handouts Sponsored by The Health … Continue reading
Posted in Finally Friday!
Tagged appeal academy, audit in healthcare, audit tools for healthcare, audit tools in healthcare, auditing in healthcare, audits in healthcare, clinical audit cycle, clinical auditing, clinical audits, finally friday, healthcare audits, inpatient, internal audit procedure, IPPS, medical audit, medical auditors, medical audits, medicare appeal, medicare audit, MOON, moon notice, NOTICE, NOTICE Act, opps, outpatient
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CMS Proposes MOON for the NOTICE Act in FY2017 IPPS Proposed Rule
One of many changes floated in the FY2017 IPPS Proposed Rule CMS introduced a standard notice to be given to observation patients after 24 hours as such, the “Medicare Outpatient Observation Notice” (MOON) that would include all of the informational … Continue reading
Posted in Industry News
Tagged appeal academy, inpatient, inpatient status, IPPS, medical audit, medicare audit, moon notice, NOTICE Act, observation service
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CMS Offers the MOON to fulfill NOTICE requirements
CMS has developed a standard notice, the “Medicare Outpatient Observation Notice” (MOON) that would include all of the informational elements necessary to fulfill the NOTICE Act’s written notice requirement. Continue reading
Posted in Academy Blog
Tagged appeal academy, inpatient, inpatient status, IPPS, medical audit, medicare audit, moon notice, NOTICE Act, observation service
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Can Denials Be Predicted Before Filing Claims?
And If So, What’s that Worth? No one has the ability to capture and analyze data from the future. However, there is a way to predict the future using data from the past. With the evolution of big data in … Continue reading
Posted in Academy Blog
Tagged appeal academy, finally friday, predictive analytics, statistical tools
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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
Posted in Finally Friday!
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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CMS 68% Settlement Offer Scorecard Worksheet
Craneware created a “scorecard” for hospitals to use in an attempt to quantify the value of CMS’ Global Settlement for appeals of RAC denials. CMS set the deadline for hospitals to decide and file to accept the settlement offer by … Continue reading
Posted in Academy Blog
Tagged appeal academy, cms 68% settlement, cms global settlement offer, craneware
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