MedicareMentor Blog

More on deductibles and coinsurance

Judith Kares — Mon, 16 Nov 2009 19:42:12 +0000

CMS recently published the Part A deductible and coinsurance and Part B deductible amounts for CY 2010. For most covered inpatient stays, as well as covered outpatient services, Medicare does not pay the entire Medicare allowable for those stays or outpatient services. Beneficiaries generally are responsible for a portion of the Medicare allowable in the [...]

Providers report first RAC denials in Florida, South Carolina

Michael Iarrobino — Thu, 12 Nov 2009 19:37:54 +0000

Over at the Revenue Cycle Institute, my colleague Andrea Kraynak has a great post on the first RAC denials that we’re seeing so far. There’s some really solid, in-depth information there regarding the experiences of two providers with RAC denials and even a discussion of particular CPT codes affected. Great information for all of us [...]

Signature for Laboratory Tests, Clarification in the MPFS Final Rule

Kimberly Hoy — Mon, 09 Nov 2009 20:49:26 +0000

This week, I would like to review a “clarification” regarding physician signatures on orders for clinical diagnostic testing that came out in the Final Rule for Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for 2010. This blog is hospital-directed and we do not normally report on physician fee schedule [...]

MedicareFind tip: How to access the inpatient-only list

Michael Iarrobino — Thu, 05 Nov 2009 14:47:04 +0000

MedicareFind users have been sending in some really great questions lately — thanks for your interest in learning how to use this product! One that I want to tackle today is about finding CMS’ list of inpatient-only procedures. CMS publishes the inpatient-only list with each OPPS final rule as Addendum E . The best way to [...]

CMS issues 2010 final rule for ambulatory surgery centers and most hospital outpatient departments

Judith Kares — Mon, 02 Nov 2009 19:48:09 +0000

CMS has released a display copy of the outpatient prospective payment system (OPPS) final rule for 2010, which also includes the 2010 changes to the rules for ambulatory surgery centers (ASCs). This final rule will be published in the Federal Register on November 20. In terms of reimbursement, OPPS hospitals that meet quality indicator reporting [...]

Sign up for our FREE MedicareFind webcast!

Michael Iarrobino — Thu, 29 Oct 2009 17:18:42 +0000

Join us Thursday, November 12, at 1 p.m. Eastern for our free MedicareFind Demonstration webcast. I’ll show what MedicareFind has to offer and demonstrate features that can help save a lot of time as you search for the source authority documents you need. I’ll also address any live questions that we receive. We’ve held a couple of [...]

CMS Announces the 2010 Medicare Premiums and Deductibles

Debbie Mackaman — Mon, 26 Oct 2009 18:05:18 +0000

CMS recently announced the CY2010 Medicare Part A deductible for inpatient hospital services. When a patient is admitted as an inpatient, the deductible will increase from $1,068 in 2009 to $1,100 in 2010. In addition, beneficiaries will pay an additional daily coinsurance of $275 for days 61 through 90 and $550 for lifetime reserve days. [...]

Implementation of permanent and nationwide RAC Program

Judith Kares — Mon, 19 Oct 2009 17:40:38 +0000

Now that CMS has implemented a permanent and nationwide Recovery Audit Contractor (RAC) Program, as authorized by the Tax Relief and Healthcare Act of 2006, hospitals need to keep themselves informed about the issues that have been approved for review in their region. Going forward, the four regional RACs will continue to review claims on [...]

October 8 Open Door Forum

Michael Iarrobino — Fri, 16 Oct 2009 13:31:22 +0000

The transcript and audio of the October 8 Hospital & Hospital Quality Open Door Forum are now available on MedicareFind. This call featured a lengthy Q&A period, including discussion of: Services that require active monitoring and their relation to observation time Charges for nursing services H1N1 resources … and more. Sign up for a free trial to MedicareFind to access the [...]

Recent OIG Reports and Medical Review Implications

Debbie Mackaman — Mon, 12 Oct 2009 17:17:03 +0000

In last week’s post, we looked at the OIG Work Plan for Fiscal Year 2010. There were many issues listed for both Part A and Part B that will be on the radar for a targeted review. Hospitals are encouraged to closely examine the OIG Work Plan as part of their annual compliance program review [...]