Managed Care Ask the Expert Answer – Robotic Surgery
Q Are commercial payers paying for additional charges billed by hospitals for robotic surgery? At least one payer that pays on a % of charges basis is not paying the charges for the robotic surgery, additional OR time, etc. and
Managed Care Ask the Expert Answer – Payer Report Card
Q We are beginning to develop a Payer Report Card and instead of "creating the wheel" do you have a report card that you have already developed that you would be willing to share with us? A Similar to your
Ask the Expert Answer: Fiscal Intermediary and Medicare Bad Debt
Q Our FI is currently disallowing our Medicare bad debts which we claimed and wrote off in accordance with our charity care policy. We believe our Medicare deductible copay amounts that we did not collect because the patient was indigent
Ask the Experts – Medicare Payment
Dale BakerDale E. Baker is the President of Baker Healthcare Consulting, Inc. (BHC), an Indianapolis based consulting firm serving over 1,000 acute care hospital clients in forty four states since 1990. BHC specializes in advising clients on Medicare geographic reclassification
Ask the Expert: Hourly Documentation for Observation Status
Q "At one point, I heard rumors that CMS was going to require hourly documentation by nursing to support Observation status. I feel as if this did not go forward, but have no hard documentation that it remains at every
Ask the Experts Answer: Legislative Requirements for Refunds
Do you know of any policy/legislation or general practices regarding a provider refunding a payer if the patient was authorized but then later found by the payer to be uncovered because they are secondary?
Ask the Experts Answer: Medicare Crossovers to Medicaid Bad Debt
If Medicaid contractualizes all or some of the amount deemed as coinsurance by Medicare, can the contractual amount be claimed as part of the bad debt on the cost report? Or, are we only able to claim the amount that Medicaid notes as being the copay or deductible on the cost report?
Ask the Expert: PMPM Payments for Case Management
PMPM payments for case management.
Ask the Expert: Achieving Transparency
Q Are there any best practices that you can recommend for transparency?
Ask the Expert: Medicare Payment for Home Health
Medicare does not distinguish payment by hospital-based or stand-alone home health agencies.