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 ...
The U.S. Medicare draft inpatient rule for fiscal 2026 discusses a number of coding proposals, although the agency seems disinclined to go along with a proposal to increase payment rates for TAVR ...
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 ...
WASHINGTON, April 2 -- The Health and Human Services Inspector General issued the following audit report (No. A-07-19-01192) on March 2023 entitled "Medicare Advantage Compliance Audit of Specific ...
A new study reveals that Medigap protection laws significantly affect Medicare plan choices for older adults in whom cancer is diagnosed. People in certain states were far more likely to switch from ...
CorroHealth reveals new technology dedicated to optimizing DRG and Revenue Integrity. With the healthcare industry grappling with a shortage of skilled professionals and payer denials, including DRG ...
Editor’s Note: A proposed rule posted to the federal government website Regulations.gov on May 9, 2016 by the Centers for Medicare and Medicaid Services (CMS) received 1,522 mailed or emailed comments ...
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 ...
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