News

Article
CMS
Hospital Management
Dr. Ronald HirschJanuary 16, 2020

The Dilemma of the Discharge Planning Conditions of Participation

CMS is expected to release instructions and sub-regulatory guidance in 2020.

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Article
CMS
Hospital Management
Physician Advisory
Angie StewartJuly 19, 2019

Outmigration of Cardiology - Logistical Challenges for ASCS + How Hospitals are Bracing for Volume Loss

CMS' 2019 Outpatient Prospective Payment System rule cleared the way for some cardiac procedures to be performed in ASCs, creating financial uncertainty for hospitals, according to Ronald Hirsch, MD, vice president of regulations and education group for R1 RCM.

 

Dr. ...

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Article
Hospital Management
Medicare
Physician Advisory
Dr. Ronald HirschJune 20, 2019

Physician Practice Audit Targets Now Become Hospital and Health System Compliance Risks

Twenty four percent of the federal budget was spent on Medicare and Medicaid in 2017.The Medicare Trust Fund is forecast to be depleted in 2026. Over 8% of Medicare fee-for-service payments in 2017 were made in error. These factors have all led Congress to put more pressure to reduce the improper payment ...

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Article
Hospital Management
Revenue Cycle
Ayla EllisonMay 16, 2019

Hospital Executives Identify the Top 3 Challenges to Revenue Cycle Transformation

Hospitals and health systems are exploring ways to transform revenue cycle processes to offset financial pressures. However, shifting to a new business model for revenue cycle management can be challenging. 

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Article
Healthcare
Hospital Management
Becker's HealthcareApril 29, 2019

Clinical Denials: Prevention is the Best Medicine

Clinical denials are a fact of life for hospitals. Providers must contend with a number of government audits conducted by several different organizations. On the private payer side, hospitals must comply with complex approval processes related to prior authorizations, admission status and medical ...

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Article
Hospital Management
Dr. Ronald HirschMarch 20, 2019

OIG Audits Part A SNF Stays for Qualifying Inpatient Admissions - And the Results are Not Pretty

The federal watchdog did not, however, decide to demand recoupments.

 

It is said that great minds think alike. And that proved to be true when the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) released its report (CMS improperly paid ...

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Article
Hospital Management
Revenue Cycle
Becker's Hospital ReviewJune 16, 2017

10 Ways Hospitals Can Improve Charge Capture

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Blog Post
CMS
Hospital Management
Medicare
Mary Lou WedenSeptember 15, 2016

Why Do Hospitals Get Accredited by The Joint Commission?

Why accreditation? Quite simply, hospitals pursue accreditation because it is required in order for their organizations to receive payment from federally funded Medicare and Medicaid programs. Once a healthcare organization achieves accreditation through The Joint ...

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Blog Post
CMS
Hospital Management
Medicare
Mary Lou WedenMay 29, 2015

The Joint Commission vs. CMS Requirements: What’s the difference?

The Centers for Medicare and Medicaid Services (CMS) and The Joint Commission are bodies designed to ensure compliance with federal regulatory standards for hospitals. The goal of these programs is to ensure quality care and patient safety. By complying with the standards set by the organizations, there is ...

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