MACs/RACs

CMS releases OPPS rule for 2016, finalizes two-midnight changes: 10 things to know

Written by Ayla Ellison for Becker’s Hospital CFO CMS released its final 2016 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule on Friday, which finalizes CMS’ proposal to alter its controversial two-midnight rule and implements previously announced modifications to CMS’ medical review strategy. Here are 10 things to know about the…

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Senate Passes ICD-10 Delay Bill

Article by Chris Dimick, Editor-in-Chief at the Journal of AHIMA. This article was originally published on the Journal of AHIMA website on March 31, 2014 and is republished here with permission. The Senate voted today to approve a bill that will delay the implementation of ICD-10-CM/PCS by at least one year. The bill now moves to…

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Providers Respond to Holder, Sebelius on ‘Troubling Indications’ of EHR Fraud

By Mike Miliard, Managing Editor, Healthcare IT News WASHINGTON – Hospital organizations are responding to a stern letter sent Sept. 24 by U.S. Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius, which warns against using electronic health records to artificially inflate Medicare and Medicaid payments. The letter – sent to the…

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Dolbey Executes Interface License Agreement with 3M Health Information Systems

Dolbey Systems, Inc. has completed an Interface License Agreement with 3M Health Information Systems of Murray, Utah. The Agreement licenses the interfacing of Dolbey’s Fusion CAC™ computer-assisted coding solution to the 3M™ Coding and Reimbursement System (CRS). For more about Dolbey’s Fusion CAC solution visit www.dolbey.com. About Dolbey Dolbey is a leader in providing dictation,…

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The Coding Enabler

By Julie Knudson for For The Record If used correctly, computer-assisted coding can help hospitals alleviate inefficiencies. As computer-assisted coding (CAC) is deployed by an increasing number of hospitals, its effect on coders is coming into focus. The evolution of workflow changes, productivity increases ahead of ICD-10, and fear of diminishing job prospects are all…

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RACs Using “Semi-Automated” Claims Review

By: James Carroll for HIM Connection, April 12, 2011 Providers familiar with automated claims reviews and complex claims reviews by the recovery audit contractors (RAC) now face another method of overpayment identification: “Semi-automated” claims review. Semi-automated review strays a bit from the automated and complex methods of overpayment identification recognized in the RAC statement of…

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