The Comprehensive Error Rate Testing (CERT) program grew out of the Department of Health and Human Services Office of Inspector General improper payment rate estimates from 1996 through 2002. Due to sample size restrictions, the Centers for Medicare & Medicaid Services (CMS) assumed responsibility because they had access to more granulated data in 2003. The […]
CMS continues to phase in the Quality Payment Program while MACRA mandates loom. The long-awaited Physician Fee Schedule (PFS) final rule, now pending publication in the Federal Register, finalizes proposed updates to the Quality Payment Program (QPP) and its two tracks — the Merit-Based Incentive Payment System (MIPS) and Advanced Alternate Payment Models (APMs) — for performance year […]
With the assistance of AI medical billers and coders can work efficiently and accurately, flagging down most of the human errors and mistakes. Recent studies show that the error rates in medical billing are reportedly pretty high. According to studies conducted by the American Medical Association and Nerdwallet, the error rates are 7.1 percent and […]
CMS is proposing changes and a three year extension to the Comprehensive Care for Joint Replacement Model (CJR), which provides a flat set of payments to hospitals for an episode of care through 90 days past patient discharge. The program was due to expire at the end of this year. The agency also wants to include outpatient […]