Market-Based MS-DRG Data Required in 2021

CMS has recently finalized new reporting requirements, published in the Fiscal Year 2021 IPPS Final Rule. The process will require hospitals to report the median payer-specific negotiated charge for all of the hospitals' Medicare Advantage organizations by MS-DRG. This information must be submitted on each hospital’s Medicare cost report on or after January 1, 2021.

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A Vitalware Case Study: Midland Health

Midland Memorial Hospital was established by prominent community leaders with one mission: “To make quality healthcare available to all residents of Midland County, Texas.” Their aim remains the same. To achieve this goal, and continue delivering high-quality care, Midland Health holds all facets of its operation to the highest standard — including revenue integrity.

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Ask a Rev Cycle Expert: Q3014 vs. E/M for Telehealth Visits?

My facility is a Rural Health Center (RHC). My providers have been doing a combination of telehealth and face-to-face visits with their patients. Do we need to bill the Q3014 instead of an E/M for our telehealth visits?

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Hospital Charge Capture: Why More Rules is Hurting Your Success

Like horsepower or seating capacity for a motor-vehicle, the number of rules referenced is offered as a measure of the sophistication and efficiency of the tool. But, the more you know about the latest advances in charge capture data and tools, the more likely you are to recognize that a larger volume of rules doesn't ensure effectiveness.

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A Price Estimator Does Not Mean Price Transparency Compliance

The Centers for Medicare & Medicaid Services (CMS) stated that hospitals that voluntarily offer an internet-based price estimator tool will be deemed to have met the requirements for display of shoppable services. However, they emphasized in the final rule that “hospitals would still be required to publish all standard charges in a machine-readable file consistent with the requirements we finalized…”. Read this article to learn what else you'll need to comply.

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New Mandatory Medicare Payment Models Announced

The Centers for Medicare & Medicaid Services (CMS) published press releases on September 18, 2020, to announce the implementation of two new mandatory Medicare payment models beginning on January 1, 2021. This article summarizes what's new.

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Articles

Market-Based MS-DRG Data Required in 2021

A Vitalware Case Study: Midland Health

Ask a Rev Cycle Expert: Q3014 vs. E/M for Telehealth Visits?

Hospital Charge Capture: Why More Rules is Hurting Your Success

A Price Estimator Does Not Mean Price Transparency Compliance

New Mandatory Medicare Payment Models Announced