medical necessity news from FierceHealthcare
NewsAHA: Hospitals appeal RAC denials with 77% success
Hospitals reported $355 million in denied claims between the first quarter of 2010 and the third quarter of 2011, according to the quarterly RACTrac survey from the American Hospital Association Read more...
Medical necessity, not patient convenience, should drive inpatient stay, CMS warns
The perennial issue of medical necessity makes a grand appearance in recent CMS guidance you may have missed. The agency sends a clear message: A patient's convenience or personal needs should not Read more...
CMS 'complex reviews' on the way by August/September
So, everyone's been bracing themselves for full-bore audits by Recovery Audit Contractors--but soon the anticipation will end. CMS has already begun automated reviews of claims to detect simple, Read more...
Court says states can decide medical necessity under Medicaid
A new decision by a federal appeals court has concluded that physicians don't have sole discretion in determining what's medically necessary treatment for children with Medicaid coverage. The Read more...
| Press ReleasesTORCH Management Services Endorses nTelagentNASHVILLE, Tenn.--(BUSINESS WIRE)-- The Texas Organization of Rural and Community Hospital Management Services, Inc. (TMSI) has endorsed nTelagent, Inc. as a preferred provider of revenue cycle Read more >> nTelagent Webinar Addresses Five Ways Hospitals Can Stop Losing MoneyNASHVILLE, Tenn.--(BUSINESS WIRE)-- On July 19, nTelagent, Inc. is hosting a complimentary webinar for hospitals and other healthcare service providers titled “Closing the Five Doors Your Accounts Read more >> Overuse of Echocardiography Costs Health System More than $890 Million per YearCareCore National Data Proves Preauthorization Reduces Wasteful Repeat Procedures BLUFFTON, S.C.--(BUSINESS WIRE)-- A new CareCore National analysis of heart disease diagnoses shows that more than Read more >> nTelagent Announces New Solution for Medical Necessity ProcessingNASHVILLE, Tenn.--(BUSINESS WIRE)-- nTelagent, Inc. has announced a new module for medical necessity processing for Medicare and other major payors at point of service, along with real-time scripting Read more >> Alpha II Signs Integration Contract with PCIS GoldClaims scrubbing functionality to strengthen the vendor’s practice management system MONTGOMERY, Ala.--(BUSINESS WIRE)-- Alpha II, a leader in healthcare coding, compliance and reimbursement, Read more >> |
