CMS Hospital QAPI Standards 2024 Updates


Comments

Post a Comment

Popular posts from this blog

Mastering DMEPOS Coding: Overcoming HCPCS Challenges

Image
Accurate coding is the backbone of medical billing and reimbursement. However, when it comes to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies – Assigning the Correct Code , things can get complicated. The AMA CPT Manual does not cover DMEPOS, and while the HCPCS Manual does, it lacks clear coding guidelines. This creates confusion for coders, compliance officers, and revenue cycle management teams who must ensure correct claim submission. Why Is DMEPOS Coding So Challenging? Unlike procedural and diagnosis coding, DMEPOS coding often lacks clear-cut instructions. Several factors make it difficult: Limited Medicare NCCI Edits – Many edits are proprietary and unpublished, leaving coders with minimal guidance. Ambiguous HCPCS Manual Guidelines – The manual includes codes but does not always specify how they should be applied. Multiple Sources of Coding Guidance – From LCDs to PDAC and manufacturer recommendations, there is no single reference for DMEPOS coding. Modifi...
Read more

Mastering The 2024 Prior Authorization Process For Medical Providers

Image
  Mastering The 2024 Prior Authorization Process For Medical Providers Prior Authorizations are a cost containment strategy that third-party payers leverage to control costs, restrict patient access to services, testing, and medications, and ultimately discourage medical providers from ordering unnecessary medical treatment. Prior authorizations are a major source of headaches for healthcare providers nationwide. Despite the intention to control costs and ensure appropriate care, the prior authorization process has been criticized for its enormous administrative burden, potential delays in necessary medical treatment, and added complexity for healthcare providers. Striking a balance between cost control and efficient patient care remains a major challenge in the healthcare industry. Join us for an insightful 60-minute webinar as we take a deep dive into the complexities of the Prior Authorization process, discuss the pearls and pitfalls, define medical necessity requireme...
Read more