Artificial Intelligence (AI) solutions have been hyped up in everything from customer service to disease diagnosis – and the healthcare revenue cycle hasn’t been exempt.
You’ve likely heard about how AI is a great fit for the healthcare revenue cycle – revenue cycle is a treasure trove of data and workflows that require manual input. Many healthcare leaders have
One of the key elements in hospital revenue cycle management success is getting a handle on cost to collect. Organizations that have realized their costs are too high have implemented many different approaches, ranging from new software to bringing on hospital billing services.
The Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2023 hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system final rule (CMS 1772-FC).
An Office of Inspector General (OIG) report found that Medicare improperly paid claims for implanted spinal neurostimulators when providers didn’t give sufficient documentation supporting medical necessity. For dates of service on or after July 1, 2021, you must ask your Medicare Administrative Contractor to authorize these services before performing the procedure in the hospital outpatient department.
On September 28, 2022, the United States District Court for the District of Columbia vacated the differential payment rates for 340B-acquired drugs in the Calendar Year 2022 Outpatient Prospective Payment System (OPPS) final rule with respect to their prospective application. The Court ruled:
