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UnitedHealth, an Insurer Switching Roles, Helps Hospitals on Medicare Billing
To hospitals, billions of dollars depend on how they define a patient's stay.
To hospitals, billions of dollars depend on how they define a patient’s stay.
Even though a patient may be in the hospital for a simple surgery, Medicare might classify the procedure as outpatient care and pay a lower fee to the hospital. Or someone may come into the emergency room complaining of chest pain but leave after just a day or two, once the tests have ruled out a heart attack. Does that qualify as an inpatient stay at a higher Medicare payment?
With government auditors and contractors cracking down on hospitals for what they contend are overbilling practices, hospitals are paying more and more attention to how they classify care when filing claims to Medicare, the federal health insurance program.
Read the full story here: http://nyti.ms/1mF2fAh
Source: The New York Times
CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection
May 7th 2024On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega, about the recent CMS final rule on Medicare Part D and Medicare Advantage.
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Coexistence of HIV, Hemophilia May Lead to Increased Presence of Coronary Artery Stenosis
May 8th 2024In patients living with HIV, the cardiovascular risk factors that come with infection may lead to an increased prevalence of coronary artery stenosis, especially in those who also have hemophilia.
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Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
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Budesonide-Based Triple Therapy Shows Best Benefit Over Dual Therapy for COPD
May 8th 2024The triple therapy of budesonide, glycopyrrolate, and formoterol fumarate showed the greatest incremental net benefit among a series of triple therapy medications that were evaluated against dual therapy for chronic obstructive pulmonary disease (COPD), according to an analysis presented at ISPOR.
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