Claims Processing
In an effort to be one of the first states to qualify for federal Medicaid EHR implementation incentive payments, the Texas Health and Human Services Commission has contracted with the CGI Group for its turnkey Medicaid Electronic Health Record solution.
The Medicare Payment Advisory Commission voted last week to recommend to Congress a 1 percent increase in Medicare hospital inpatient and hospital outpatient prospective payment system rates for 2012, in addition to a 1 percent pay rate increase for physicians.
A New Orleans-area doctor and the owner and operator of a medical equipment company have been sentenced to prison on charges of healthcare fraud involving durable medical equipment, according to the departments of Justice and Health and Human Services.
Orlando's Florida Hospital, billed as the largest and busiest hospital in the United States, has entered into an agreement with ERIS Medical Technologies to implement that company's automated .net charge capture software.
CMS has posted an "emergency update" to the 2011 Medicare physician fee schedule (MPFS) files, reflecting recent statutory changes and certain technical corrections.
A new OIG report, “Questionable Billing for Medicare Outpatient Therapy Services,” reviews 20 counties with the highest Medicare outpatient therapy payments per beneficiary and overall high outpatient utilization levels in 2009.
The Bethesda Healthcare System, a not-for-profit, two-hospital system in Boynton Beach, Fla., intends to redesign its revenue cycle processes, adding a fully automated financial and clinical patient record.
CMS has issued a new transmittal to update its timeline for implementing claims edits that will deny claims for services ordered or referred by a physician or other eligible professional who does not have an approved file in PECOS.
The National Association of Insurance Commissioners has adopted model language for health insurance exchanges designed to provide guidance to individual states as they establish insurance exchanges as required under health reform.
The Centers for Medicare & Medicaid Services will soon be outfitted with new state-of-the-art fraud fighting analytic tools to prevent wasteful and fraudulent payments in Medicare, Medicaid and the Children's Health Insurance Program.