A key objective is to enable updates to the MS-DRG payment rates that are no longer dependent on gross charges billed by hospitals that are reduced to cost using hospitals' cost report data. Included ...

Connolly Healthcare has announced the first issues approved for complex RAC review, so providers in several RAC Region C states could begin seeing medical record documentation requests at any time.

The process of bundled payments — in which hospitals, physicians, post-acute care providers and other receive a lump sum to cover a specific episode of care over an allotted period of time — is still ...

The sky is no longer falling. It has fallen, period. Analysis of the newly posted issues from Connolly Healthcare and HDI (Health Data Insights) reveals that for first time Rehabilitation Facilities ...

Diagnostic-related groups (DRGs) are how Medicare and some other health insurance companies categorize hospital costs to determine how much to pay for a hospital stay. With DRGs, the payment amount ...

In the complicated world of hospital billing, there’s a fine line between maximizing reimbursement and gaming the system. A new study shows a troubling trend as hospitals increasingly code for “sicker ...

Hospitals decide how much to bill Medicare for your care based on your diagnostic-related group (DRG). They then charge Medicare based on your DRG tier instead of separately for each of your medical ...