Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

CMS

Medicare Home Health Agencies Face Upcoming Payment Changes

by Jacqueline DiChiara

The Medicare home health prospective payment system (HH PPS) can expect payment changes next year, confirms an announcement from the Centers for Medicare & Medicaid Services (CMS). These payment changes aim to ensure greater payment...

CMS Reports 10% Denial Rate in 4.6M Daily Oct. ICD-10 Claims

by Jacqueline DiChiara

The ICD-10 transition has come and gone. Although primary affirmations with large numbers to boot have been reported thus far throughout the month of October, is it perhaps too soon to declare ICD-10 implementation a merely underwhelming endeavor?...

CMS: It’s Quality Over Quantity with Value-Based Purchasing

by Jacqueline DiChiara

The ever familiar “Show me the money!” mentality only rings true in the case of quality over quantity regarding hospital payments, implies the Centers for Medicare & Medicaid Services (CMS). The Hospital...

1 Million First Attempt ICD-10 Claims Yield 99% Success Rate

by Jacqueline DiChiara

Nearly 1,000,000 ICD-10 claims were successfully processed the first time around within the first three weeks of October, confirms a press release from the Advanced Data Systems Corporation (ADS). "ADS was ready for ICD-10...

CMS Issues Proposed 2017-2018 Basic Health Program Notice

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) is releasing newly proposed methodology, to be published today. CMS will be accepting both electronic and non-electronic commentary shortly. Yet another of many payment rules, the 53-page...

CMS Requests Merit-Based Incentive Payment System Discussion

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) will publish a proposed rule tomorrow (CMS-3321-NC2) requesting information about the implementation of the Merit-Based Incentive Payment System (MIPS) and allowing for a comment period...

AHA: Hospital Quality Star Rating System Needs Improvement

by Sara Heath

In an effort to measure hospital and patient care quality, the Centers for Medicare & Medicaid Services (CMS) has introduced the Hospital Quality Star Rating System. However, according to a recent letter from the American Hospital Association...

GAO Advises CMS to Clarify RAC’s Medicare Audit Objectives

by Sara Heath

A recent study by the Government Accountability Office (GAO) has found that the Centers for Medicare & Medicaid Services (CMS) needs to be more hands-on when working with Medicare Part D recovery audit contractor (RAC) programs. CMS began...

CMS Announces Final Rule Implementing Quality Care in SNFs

by Sara Heath

Value-based payment and quality care continue to prove high on the Centers for Medicare & Medicaid Services’ (CMS) agenda. On July 30, the Centers for Medicare & Medicaid Services (CMS) announced their final rules for the fiscal...

CMS Revises ICD-10 FAQ List for Billable Code Clarification

by Sara Heath

Following the July 27 issued ICD-10 frequently asked questions list, the Centers for Medicare & Medicaid Services (CMS) has updated some of the information. These updates primarily clear up confusion regarding family codes and what qualifies...

NAMD Says Medicaid Managed Care Rule Restricts Healthcare Reform

by Sara Heath

In response to the proposed regulations of Medicaid managed care, the National Association of Medicaid Directors (NAMD) submitted a list of comments to the Centers for Medicare & Medicaid Services (CMS), according to a statement made by Matt...

CMS Approves Press Ganey to Administer PQRS CAHPS Survey

by Sara Heath

On July 27, 2015, Press Ganey Holdings, Inc. announced in a press release that it will be one of the vendors approved by the Centers for Medicare & Medicaid Services (CMS) to administer the Physician Quality Reporting System Consumer Assessment...

Summary of CMS’s Top 5 Proposed Payment Rules, Revisions

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) has continuously released a steady stream of payment policies and physician fee schedules. As RevCycleIntelligence.com reported in a summary of top 6 previously proposed payment rules and...

CMS Administrator Slavitt Writes ICD-10 Letter to Providers

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) released a letter today addressed to Medicare providers about ICD-10. According to CMS Acting Administrator Andrew M. Slavitt, the healthcare industry and greater community will thrive...

Praise for Patient-Centered Payment Models, Bundled Payments

by Jacqueline DiChiara

The Centers for Medicare & Medicaid Services (CMS) apparently gets a big thumbs up this week. Leading consumer advocacy group, the National Partnership for Women & Families (NPWF), openly praises CMS for its efforts regarding patient-centered...

CMS Announces HPID Final Rule Public Commentary Period

by Jacqueline DiChiara

The Department of Health and Human Services (HHS) released a Request for Information (RFI) earlier this month on the Health Plan Identifier (HPID). HPID – a standard identifier for health plans – is required to be adopted under the...

Can Next Generation ACO Drive Patient Engagement?

by Jacqueline DiChiara

The Centers for Medicare and Medicaid Services (CMS) Innovation Center recently revealed plans for a new payment initiative – the Next Generation Accountable Care Organization (ACO) Model – which focuses on a unique accountable care...

Physicians Struggling with Consistency in ICD-10 Transition

by Jacqueline DiChiara

ICD-10 implementation involves a complicated code conversion that physicians struggle to comprehend, and the mandated code change raises substantial financial concerns. RevCycleIntelligence.com spoke with Andrew Boyd, Assistant Professor of Biomedical...

CMS Announces Next Generation ACO Model Open Door Forum

by Jacqueline DiChiara

The Center for Medicare and Medicaid (CMS) Innovation Center revealed plans earlier this month for a new examination of accountable care with larger financial risk for hospitals and doctors and more choice for patients. As RevCycleIntelligence.com...

CMS Announces Next Generation ACO Model Initiative

by Jacqueline DiChiara

The Department of Health and Human Services (HHS) has announced its latest initiative for the Centers for Medicare & Medicaid Services’ Innovation Center (CMS Innovation Center), the Next Generation Accountable Care Organization (ACO) Model...

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