Compliantly Optimize Healthcare Reimbursements
Denials and underpayments are defects in the revenue cycle that indicate a provider’s inability to comply with payer requirements or a payer’s inability to accurately pay a claim. CRN Healthcare Solutions works with practices to evaluate and implement lean process workflow denials management so that every dollar not paid which should have been paid is addressed and followed up.
CMS Proposes a Single E/M Payment, Streamlined Doc Requirements
The Federal Register scheduled for publication on July 27, 2018 will include a proposal for a single E/M payment for new outpatient services, and a different single E/M payment for established outpatient E/M services, regardless of the E/M level subm… For more,...
When Non-Covered and Covered Procedures Are Performed
There are times when a physician will be performing both covered and non-covered procedures at the same operative session. For example, the surgeon may be performing a septoplasty for a deviated septum (J34.2) and nasal obstruction (J34.89), which is … For more,...
New Jersey’s New Law Aimed Eliminates “Surprise” Medical Bills
The New Jersey (NJ) governor signed a new law designed to curb the impact of costly “surprise” medical bills when a patient sees a non-participating provider during an admission. The bill is quite complex but tries to balance the needs of patients, … For more,...
Anthem Investigator Charged with Fraud
A former fraud investigator for Anthem, Inc. is one of five people indicted on federal healthcare fraud charges. Those indicted participated in a multi-year scheme to commit fraud against at least eight health insurance companies. The fraud investigat… For more,...