5 nuances of Medicare billing
Richburg, B.K.
Healthcare Financial Management Journal of the Healthcare Financial Management Association 62(1): 72-76
2008
ISSN/ISBN: 0735-0732 PMID: 18351255 Document Number: 615619
Here are steps providers should take to ensure appropriate Medicare payment: Group claims under MS-DRG on "bill drop." Small urban or rural hospitals: Investigate the possibility of attaining critical access hospital or sole community hospital status. Identify managed care contracts that pay therapies from the physician fee schedule, then audit payments to ensure the nonfacility rates are being paid. When FIs and MACs bundle procedures that are not performed at the same time, all such payments should be appealed.