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Tag Archives: medical audit
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 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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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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“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!” Will CMS or Congress Kill Medicare’s 3-Day Qualifying Stay for SNF Coverage?
3-Day Stay for SNF Coverage: Will It Stand or Not? Regs Review & Another Quiz from Dr. Pahuja Plus: Interview with a Physician Advisor Double Certified as a Medical Auditor In a previous week, we heard from two practicing Physician … Continue reading
