...since hospital pricing, Hospital Information Systems, and patient care are complex and highly varied, arguments about pricing were difficult to dispute without comparative data...
hospital compliance auditing
Tactical mistakes for Price Transparency include failing to fully adopt CMS regulations, and utilizing practices that create barriers to data access.
Hospitals failing to meet CMS mandates are not only being called out in the news; they are also being contacted for corrective action plans and risk mounting fines.
in the 2022 Price Transparency Final Rule, CMS discusses the statutory basis and background of the Rule, intention of the regulation, ongoing concerns with the industry’s compliance to the rules, 2022 proposals, summary, and responses to public comments, and final decisions.
CPT® Consumer-Friendly descriptions have been in existence for some time, but were never a reliable data element for wide-spread utilization in hospital charging master files.
This blog post includes common challenges as well as the best five 'Insider Tips’ for a more proactive approach when selecting a new CDM tool.
As of 1Q19, there are five V range Intraocular Lens codes as noted in the table below. Consider OPPS Status Indicators (or I/OCE edits if CAH payment methodology) to know which codes can be billed to Medicare.
on June 23, a federal judge upheld CMS regulations for January 2021 expanded price transparency requirements
Chargemaster Guide for the COVID-19 Public Health Emergency: Part 2 Laboratory Public Health Emergency CDM topics
Laboratory departments will need to stay vigilant for additional AMA and CMS updates for COVID test coding as well as other regulatory changes during the Public Health Emergency period.
Chargemaster Guide for the COVID-19 Public Health Emergency: Part 1 – COVID-19 PHE Background & Resources
Proactive monitoring of CMS and other payer coding and claims requirements is more essential now than ever to ensure correct charging, billing and payments.