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Test Your Knowledge – June 2022

Test Your Knowledge – June 2022

A 70-year-old Medicare beneficiary presented via EMS with depressed mental status, hypoxia and ST segment elevations on EKG.  1228: Vital signs upon arrival Temp 97, HR 120, RR 13, BP 86/67, oxygen saturation 93% on 4L/min  1240: Initial labs demonstrated troponin...

Bulletin 15 – What you need to know about the OIG April 2022 Report

Bulletin 15 – What you need to know about the OIG April 2022 Report

Versalus Health Comments on the April 2022, Office of Inspector General Report on “Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care” Summary: The Center for Medicare and...

Bulletin 14 – CMS updates to MCPM Ch. 30

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...

Bulletin 13 – OPPS

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...

Bulletin 12 – OPPS

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...