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.
OIG Expects to Recover $5.9B in Healthcare Fraud
The Office of Inspector General (OIG) expects a banner year in recoveries stemming from fraud investigations and audits. According to the OIG semiannual report, released Dec. 2, the U.S. Department of Health and Human services (HHS) stands to recoup a… For more,...
Prevent Medicare Claims Denials in 2020
Medicare has been issuing beneficiaries new member cards with Medicare Beneficiary Identifiers (MBI) in place of Social Security Numbers (SSNs) for more than two years. 2019 was a phase-in period when Medicare would accept either a beneficiary’s Socia… For more,...
Is Direct Primary Care the Answer?
Direct primary care (DPC) is one of the newer forms of plans offered by primary care providers to their patient populations. Some see DPC as an alternative to traditional third-party payment for care and other more recent models such as concierge med… For more,...
OIG to Audit Risk Adjustment Coding
Consistent with previous reporting, the Office of Inspector General (OIG) has added to its 2020 Work Plan a targeted audit of Medicare Advantage (MA) programs for risk adjustment diagnosis codes. This is not the first time federal agency has targeted … For more,...