A long-term care provider that requested clearance for a system of paying an agency to refer patients is in the clear.
Ask the payment expert: I am seeing an increase in Medicare Replacement Policy additional document requests....
By
Caryn Adams
Oct 01, 2020
I am seeing an increase in Medicare Replacement Policy additional document requests. How should we respond?
CMS: Stop ‘info blocking’
By
James M. Berklan
Mar 07, 2019
Federal regulators struck hard toward improving interoperability and information sharing between skilled nursing facilities and other providers.
Ask the payment expert … about RACs
Apr 06, 2015
I thought the Recovery Audit Contractors were on hold, so why did I receive a request from our RAC for a Medicare Advantage resident?
Claims facing more scrutiny from auditors, survey shows
By
James M. Berklan
Oct 01, 2012
If providers feels like they’re under more intense scrutiny than ever before from Medicare recovery audit contractors, there is a good reason: They are.
RACs recoil against bills
By
James M. Berklan
Jul 01, 2013
Independent Medicare auditors are criticizing two measures that would put stricter controls on Recovery Audit Contractors.
Ask the Payment Expert about … expedited review
By
Patricia Boyer
Sep 04, 2015
The expedited review process was developed so a resident could quickly appeal the process if he or she disagreed when a facility decided that a resident is no longer covered under skilled services.
Extra audits clog and freeze Medicare appeals process
By
James M. Berklan
Mar 01, 2014
Providers who want to have an administrative law judge consider a Medicare claim appeal can save their breath and memos for now.
Cases subject to escrow
By
James M. Berklan
Oct 01, 2013
Federal regulators have expanded the use of escrow accounts so that as of this month, providers will be subject to their use for any kind of deficiency from a standard or complaint survey that draws a...
CMS wants burdens eased
By
James M. Berklan
Feb 01, 2013
Providers will have their say about the future of Medicare Administrative Contractors.