Practice Audit Targets Become Compliance Risks for Hospitals

Dr. Ronald HirschJune 20, 2019

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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Becker's Hospital Review: Challenges to Revenue Cycle Transformation

R1 RCMMay 16, 2019

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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RACMonitor: OIG Audits Part A SNF Stays

Dr. Ronald HirschMarch 20, 2019

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 millions of dollars for skilled ...

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HFMA First Illinois Chapter Newsletter: Future of Hospital Cardiac Programs in Flux

Dr. Ronald HirschMarch 13, 2019

Much of the talk in the last few months has been about the changes proposed by the Centers for Medicare & Medicaid Services (CMS) to the physician evaluation and management code selection and payment regulations in the 2019 Proposed Physician Fee Schedule Rule. And there was a collective national sigh of relief when CMS elected to defer any ...

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10 Ways Hospitals Can Improve Charge Capture

Becker's Hospital ReviewJune 16, 2017

Charge capture is a crucial part of the revenue cycle process, as healthcare organizations that fail to accurately document information on the care provided at their facilities can potentially lose millions in revenue.

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Why Do Hospitals Get Accredited by The Joint Commission?

R1 RCMSeptember 15, 2016

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 Commission or another ...

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

R1 RCMMay 29, 2015

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 greater consistency of care, ...

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