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This detailed look at each level of Medicare appeals gives complete information on time periods as well as contact information.
The ARRA passed in February included several details that ultimately affect Medicare. Take a look at how the legislation changes Medicare.
Medicare reimbursement for education has become a complex reporting and documentation process. These strategy suggestions may lessen the complexity.
When the Centers for Medicare and Medicaid Services (CMS) unveiled a long-awaited revamped rule for the cost report appeal process last May, it changed the way the appeals are handled dramatically—at least as they relate to provider’s responsibilities. In addition, regulations that had been on the backs for years, and not vigorously enforced, will now be receiving a closer look by the PRRB.
The Medicare Disproportionate Share Hospital (DSH) adjustment provision has been in effect since 1986. The payment adjustment was designed to compensate hospitals that care for a greater proportion of low-income patients. Are you calculating yours correctly?
The Centers for Medicare and Medicaid Services (CMS) recently implemented a new Final Rule that will substantially revise the process used to contest a disputed decision from a Fiscal Intermediary (FI) on a case involving Medicare payments before the PRRB--the Administrative tribunal appointed by Congress to adjudicate disputes.
In practice, the JSM did little to clarify matters and provide objective guidance on the issue; instead it created confusion and controversy and spawned several lawsuits that have muddied the waters even further.
Quality Assurance leaders like the National Quality Forum (NQF), a coalition that represents the consensus of many healthcare providers, consumer groups, professional associations, purchasers, federal agencies, and research and quality organizations, maintain that health care outcomes are tied directly to patient perceptions of the care they receive.
The PRRB is an Administrative tribunal appointed by Congress to adjudicate disputes related to provider Medicare issues--an independent panel to which a certified Medicare service provider may appeal if it is dissatisfied with a final determination of its fiscal intermediary or the Centers for Medicaid & Medicare Services (CMS). A decision of the Board may be affirmed, modified, reversed or vacated and remanded by the CMS Administrator.
Hospital Occupational Mix has not always worked as it was intended. Read about the current state of occupational mix and how it might affect your hospital system.
The reporting of charity care and bad debt has come under increased scrutiny recently. Read the keys to reporting uncompensated care.