CMS Works to Ease RAC Audit Burden, Reduce Denial Backlog

Long a thorn in the side of hospitals nationwide, Recovery Audit Contractor (RAC) program recently underwent substantial changes which CMS say will make the audit process significantly less burdensome for providers.

prescription bottles of oxycodone with loose pills

Support Act Creates New Bundled Opioid Treatment Payments

Hospitals on the front lines of the opioid epidemic have new tools to address the scourge of opioid misuse and addiction, including bundled Medicare reimbursements for holistic treatment services.
On Jan. 1, 2020, a bundled Medicare payment became available to hospitals to support comprehensive treatment of opioid disorders. The new reimbursement opportunity is one of several provisions in the act aimed at mitigating opioid misuse risk among Medicare beneficiaries.

Ready to Meet PAMA Outreach Lab Reporting Requirements?

Hospitals nationwide are scrambling to comply with a new reporting mandate announced by Medicare in early 2019 within a densely written and widely misunderstood transmittal. The reporting, which is mandated by PAMA, requires applicable hospital outreach laboratories and physician clinics that perform specimen-only lab testing to report their commercial payor payment rates for lab services by the end of March 2020 or potentially face fines of more than $10,000 per day.

Money being swept up with paper trash

3 Strategies for Reducing Non-clinical Healthcare Spending Waste

Waste in the U.S. healthcare system has decreased slightly over the past eight years, but it remains an enormous problem, consuming 25% of all healthcare dollars. Cutting systematic waste in the areas of pricing and administrative complexity while reducing the risk of costly fraud, waste and abuse audits requires an approach grounded in empirical evidence and supported by a capable staff and advanced technologies. Learn how healthcare organizations can use external expertise to help reduce healthcare waste.

EHRs Underperforming on RCM

With the majority of hospitals and health systems struggling to achieve the full potential of their electronic health systems (EHR), a recent survey found 46% of respondents are collaborating with external organizations, including outsourcing and vendor partnerships, to decrease revenue cycle costs and increase economies of scale.

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