Regulatory Bulletins

Key takeaways and insights from CMS updates

Bulletin 14 – CMS updates to MCPM Ch. 30

CMS Issues Update to the Medicare Claims Processing Manual Chapter 30 Section 200: Financial Liability Protections Overview On January 21, 2022, CMS released a Medicare Learning Matters (MLN) announcing a change request (CR 12546), resulting in substantial edits to...

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Bulletin 13 – OPPS

Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule Overview On November 2, 2021, CMS released the anticipated CY 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center...

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Bulletin 12 – OPPS

 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule Overview On July 19, 2021, CMS released the anticipated CY 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical...

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Bulletin 05 – COVID-19

COVID-19-Related Considerations When Determining Medicare & Medicare Advantage Admission Status 1. Public Health Emergency Declarations As utilization review and compliance experts within your hospitals, it is imperative that you understand the impact that waivers...

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Appeals

Appeals

Learn how Versalus Health’s innovative appeal solutions can drive increased revenue for your hospital.

Data and Analytics

Data and Analytics

Leveraging Key Insights From Data Analysis   Data is full of potential, but on its own, it's just numbers. With the right partner, these numbers — denial rates, inpatient rates, CMI, and more — are transformed into insights to guide hospital and health system’s...

Physician Advisors

Physician Advisors

Today’s hospitals and health systems require physician clinical expertise tied to in-depth knowledge of documentation best practices, length of stay management, quality, contracting, billing, and compliance, among other disciplines. Hospitals and health systems have invested significantly in building internal Physician Advisor teams to address these needs.

Regulatory Compliance

Regulatory Compliance

Regulatory compliance is a complex issue for many healthcare facilities, especially as new, updated regulations supersede old ones. Hospitals and health systems may find it challenging to stay up to date with regulatory changes impacting Utilization Management (UM) and the clinical revenue cycle and determine the implications of these regulatory changes on the organization’s processes. Fortunately, Versalus Health can assist your organization with keeping up to date with regulatory changes. We keep our finger on the pulse of regulatory oversight, helping facilities understand the newest regulations, their implications for the Clinical Revenue Cycle , and the latest trends in audits

Utilization Management

Utilization Management

Hospital utilization management teams ensure patients get the proper care and services they need in compliance with regulations and payer contracts without overusing resources. Lying at the intersection between clinical decisions, documentation, regulations, payer...