New Workflow Manages DRG Mismatches

Workflow increases productivity, while proving itself to be successful in reconciling DRG mismatches. When asking many clinical documentation improvement specialists (CDISs) what they dislike most

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The Attack 340B Is Well Funded

Is the membership of PHARMA.org made up almost exclusively by companies that sell high priced drugs and devices? Unless you live under a rock, you

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Medical Audits Poised to Surge

Providers need to stay alert as to the areas being targeted for review by federally contracted entities. Medicare Part A covers, among other things, inpatient

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Coding Audits: A Compliance Necessity

Coding audits provide insight into the process of coding itself. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has

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CMS Announces the Resumption of Medicare Audits

The hiatus of audits was short-lived.  The ongoing COVID-19 pandemic and resulting public health emergency (PHE) has brought about massive and quick changes in the

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Best Practices for How to Avoid an Audit

As payors both in government (Medicare) and the commercial arena (private plans) see the recoupment rate of services billed incorrectly or non-compliantly skyrocket, the payor

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