Healthcare Auditing involves more than just validating data. It also includes understanding the coding, charging and billing rules, as well as Regulatory Guidance, around the services being audited.

OIG to Audit CMS’ Use of Remote Patient Monitoring Service - 4/19/23

What’s on the OIG’s audit list as the PHE (Public Health Emergency) winds down?

OIG Audit of CMS Overpayment Recovery - 8/31/22

OIG audit identifies that CMS failed to collect more than $200 million in overpayments.

Revenue Integrity - 6/10/22

The future of hospital and revenue integrity advocacy. See a NAHRI (National Association of Healthcare Revenue Integrity) Q&A that addresses this topic.

Reporting Patient Supplied Drugs - 10/27/21

More patients are bringing their drugs with them to the hospital for various reasons. What does CMS say about reporting these drugs on the claim?

A Data-Driven Denial Prevention Program - 10/20/21

Prevention is better than a cure, but that’s often easier said than done when it comes to denials. The challenge is two-fold: disagreements about accountability and responsibility and a lack of comprehensive data to understand root causes and trends early enough to act. These are complex problems that require organization-wide commitment—but the payoff more than makes the case.

Telehealth Services - 9/23/21

Medicare pays specific Part B physician or practitioner services provided through a telecommunications system. Telehealth services substitute for an in-person visit.

Transplant Billing - 8/9/21

Transplant billing rules can be complex. See a NAHRI Q&A that addresses this topic.