One Process at a Time

By: Sandy Sage RN, Revenue Analyst I’ve worked in the healthcare revenue cycle for 18 years. I’ve seen hospitals bought, sold, closed and I’ve seen them struggle and flourish. With regulations being imposed daily, and weekly, hospital staff have soldiered on and worked hard to keep their hospitals open. The one thing that every person I have met, that works …

Medicare: Two Day Rule

Remember to review the policy! It has been brought to our attention that many member hospitals can benefit from this Medicare reminder, so our team of experts requested the following be shared: one-day stays with both Medicare and Managed Care claims are appearing frequently. Medicare policy is that for a patient to be considered inpatient, then the stay should exceed …

Medicare Advantage Overpayment Issue

Important Update: Regarding Jurisdiction J (JJ) Medicare Advantage (MA) Overpayment Issue Attention JJ Part A providers: Palmetto GBA will extend the cancellation and recoupment date of these claims from July 1, 2018 to July 15, 2018, to allow providers additional time to research their patient account records and provide us with information to review and consider for exception. Please review …