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There is still a lot of confusion regarding the impact on Medicare beneficiaries from eliminating the Inpatient-Only List. As recent as last week, an article from The Washington Post titled New cost-cutting Medicare rule may add costs to patients, discussed how this...
BFCC-QIO National Claim Review Contract Awarded for Short Stay and Higher-Weighted Diagnosis Related Group (HWDRG) Claims Overview Livanta, a Centers for Medicare & Medicaid Services’ (CMS) Beneficiary and Family Centered Care – Quality Improvement Organization...
By Joseph Zebrowitz, MD Denials Are Bad…Maybe Not One of the central tenets of utilization management is that “denials are bad.” Our hospitals have developed a myriad of Key Performance Indicators (KPIs) that reflect this: we track denial rate and total number of...