site neutral

Medicare Advantage Denials

We have talked about managing denials in the past, but have rarely gotten payor specific. In this recent article from Healthcaredive.com, they targeted in on Medicare Advantage plans. This stems from an investigation by the HHS Office of Inspector General. They have discovered a high number of overturned denials for Medicare Advantage organizations. Three-fourths between …

Medicare Advantage Denials Read More »

site neutral

Pros and Cons of Site Neutral Payments

Last week saw a push from hospitals to lobby lawmakers about CMS’s proposal for site neutral payments. The site neutral payment proposal would be to pay the same rate for services delivered at off-campus hospital outpatient departments and independent doctor’s offices. According to CMS, they could save $610 million and patients could save $150 million …

Pros and Cons of Site Neutral Payments Read More »